Nicole Kelly Wong, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

098256 Issued in NY

Practice address

21 Fairmont Ave Ofc 28
Poughkeepsie, NY 12603-2409

Phone

(845) 202-0634

NPI assigned

Aug 27, 2024

Last updated

Jan 21, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wave Counseling LCSW

  • Clinical Social Worker
  • Poughkeepsie, NY
  • NPI 1609690924
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1063246577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 FAIRMONT AVE OFC 28",
            "city": "ARLINGTON",
            "state": "NY",
            "postal_code": "126032409",
            "telephone_number": "845-202-0634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 FAIRMONT AVE OFC 28",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126032409",
            "telephone_number": "845-202-0634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "NICOLE",
        "middle_name": "KELLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-27",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "098256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Womens Health Physicians of the Hudson Valley PLLC
• Seblewongel Solomon Wondyrad, M.D.
• Lonnie Wong-Trufanoff, MA
• Alice Wong
• Jeffrey Wong, MD
• Sunhee D Woo, MD
• Sandra K Wood (Mannino), LPN
• Gloria Denise Wood
• Kennisha Wood, LPN
• Kourtney Wood

• Clinical Social Worker in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.