Provider Demographics
NPI:1649987348
Name:WONG, KADI-ANN VERNA (MSW)
Entity type:Individual
Prefix:MISS
First Name:KADI-ANN
Middle Name:VERNA
Last Name:WONG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 CAROLINA HEMLOCK DR
Mailing Address - Street 2:
Mailing Address - City:LOCUST
Mailing Address - State:NC
Mailing Address - Zip Code:28097-0079
Mailing Address - Country:US
Mailing Address - Phone:516-667-4295
Mailing Address - Fax:
Practice Address - Street 1:415 CAROLINA HEMLOCK DR
Practice Address - Street 2:
Practice Address - City:LOCUST
Practice Address - State:NC
Practice Address - Zip Code:28097-0079
Practice Address - Country:US
Practice Address - Phone:516-667-4295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0184401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical