Provider Demographics
NPI:1750527073
Name:SIEW, SOOK FONG (LCSW)
Entity type:Individual
Prefix:MISS
First Name:SOOK FONG
Middle Name:
Last Name:SIEW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:SOOK FONG
Other - Middle Name:
Other - Last Name:SIEW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:65 PIKE ST
Mailing Address - Street 2:APT 2F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-7355
Mailing Address - Country:US
Mailing Address - Phone:917-887-9288
Mailing Address - Fax:
Practice Address - Street 1:65 PIKE ST
Practice Address - Street 2:APT 2F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-7355
Practice Address - Country:US
Practice Address - Phone:917-887-9288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-17
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0568481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical