Johnny K Wong

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

028184 Issued in NY

Practice address

2846 Stillwell Ave
Brooklyn, NY 11224-2624

Phone

(718) 975-4888

NPI assigned

Sep 22, 2022

Last updated

Jun 11, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/cybermed_idcc

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.

• Interborough Developmental and Consultation Center, Inc.

  dba LSA Recovery

  • Case Management Agency
  • Brooklyn, NY
  • NPI 1588611842
  Medicare reassignment
• Sla Associates LLC

  dba IDCC Health Services

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1528447679
  NPD
• Interborough Developmental and Consultation Center, Inc.

  dba IDCC Health Services

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1912867433
  NPD (past)

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1518680719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2846 STILLWELL AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242624",
            "telephone_number": "718-975-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2846 STILLWELL AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242624",
            "telephone_number": "718-975-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "JOHNNY",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-22",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "028184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ivan Wong, M.D.
• Jake Wong
• Jason Wong
• Jem Wong, LMFT
• Jessica Venessa Wong
• Jonathan Wong
• Jonathan Tak-Keung Wong, MD.
• Joyce Wong, NP
• Juan S Wong
• Kaitlyn Lin Wong, M.D

• Clinical Psychologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.