Individual provider Active NPI

Steven Hing Wong, LPCC, LADAC

  • Professional Counselor
  • Albuquerque, NM
National Provider Identifier
1508055013
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0108421 Issued in NM
Practice address
2309 Renard PL SE Ste 117
Albuquerque, NM 87106-4264
Phone
(505) 401-5976
Fax
(505) 256-5171
NPI assigned
Oct 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0108411 NM
Professional Counselor 101YP2500X 0108421 NM Primary

Addresses

Primary practice location

2309 Renard PL SE Ste 117
Albuquerque, NM 87106-4264

Mailing address

424 Bryn Mawr Dr SE
Albuquerque, NM 87106-2206
Phone (505) 401-5976

Other practice location 1

1400 Carlisle Blvd NE
Suite A
Albuquerque, NM 87110-5658
Phone (505) 242-3050

Other identifiers 1

IdentifierTypeStateIssuer
65873874MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240512000069 NM Practitioner - Mental Health Counselor 1153762125 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0108411NMMDAddiction (Substance Use Disorder) Counselor
0108421NMMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pathfinder Visions, Inc. Professional CurrentSince Jan 5, 2005 Accepting new patients

Locations

107 Bryn Mawr Dr SE
Albuquerque, NM 87106
Phone (505) 681-0708

1400 Carlisle Blvd NE
Ste A
Albuquerque, NM 87110
Phone (505) 242-3050

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1192838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1508055013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 BRYN MAWR DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062206",
            "telephone_number": "505-401-5976",
            "fax_number": "505-256-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 RENARD PL SE STE 117",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064264",
            "telephone_number": "505-401-5976",
            "fax_number": "505-256-5171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Carlisle Blvd NE",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871105658",
            "country_code": "US",
            "telephone_number": "505-242-3050",
            "fax_number": "505-256-5171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "STEVEN",
        "middle_name": "HING",
        "name_prefix": "Mr.",
        "credential": "LPCC, LADAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-20",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0108411",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0108421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65873874",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.