Provider Demographics
NPI:1619696507
Name:WONG, BRITTANY (MSW, LMSW)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 SOLOMONS ISLAND RD N STE 119
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-3917
Mailing Address - Country:US
Mailing Address - Phone:410-535-5400
Mailing Address - Fax:410-535-2220
Practice Address - Street 1:900 BESTGATE RD STE 210
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7922
Practice Address - Country:US
Practice Address - Phone:410-267-3706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
MD31407104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional