Provider Demographics
NPI:1811958283
Name:WONG, KAREN JOY (LCSW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:JOY
Last Name:WONG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4602 SUNNY MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-2783
Mailing Address - Country:US
Mailing Address - Phone:801-282-9590
Mailing Address - Fax:
Practice Address - Street 1:7575 S 900 E
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-5100
Practice Address - Country:US
Practice Address - Phone:801-208-1031
Practice Address - Fax:801-208-1987
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT140030-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical