Kennedy Wong, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS019805 Issued in PA

Practice address

22 N Pennell Rd
Media, PA 19063-5520

Phone

(267) 551-1984

NPI assigned

Jun 4, 2022

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1654300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1861131088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 CARPENTER ST UNIT 1F",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191473910",
            "telephone_number": "302-463-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 N PENNELL RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635520",
            "telephone_number": "267-551-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KENNEDY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-04",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS019805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helen Anne Wolfson, MD, LLC.
• Bradley Mark Wolgast
• George J Wolters, DO
• Women'S Health Care Group of PA
• Womens Healthcare Group of PA.
• Jennifer Wood
• Valerie Wood
• Rachel Elizabeth Woodruff, NP
• Nancy Slater Woolf, MD
• Paul D Woolf, MD

• Clinical Psychologist in Media, PA
• Providers in Media, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.