Provider Demographics
NPI:1740800358
Name:WU, XIAOHONG
Entity type:Individual
Prefix:
First Name:XIAOHONG
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 5TH AVE RM 901
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6682
Mailing Address - Country:US
Mailing Address - Phone:917-730-1826
Mailing Address - Fax:833-259-3486
Practice Address - Street 1:303 5TH AVE RM 901
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6682
Practice Address - Country:US
Practice Address - Phone:917-730-1826
Practice Address - Fax:833-259-3486
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2025-10-20
Deactivation Date:2020-06-24
Deactivation Code:
Reactivation Date:2020-07-01
Provider Licenses
StateLicense IDTaxonomies
NY012521101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM610020Medicaid