Provider Demographics
NPI:1437427937
Name:KONG, ISAIAH YANLOK (LCSW)
Entity type:Individual
Prefix:MR
First Name:ISAIAH
Middle Name:YANLOK
Last Name:KONG
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:YAN
Other - Middle Name:LOK
Other - Last Name:KONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:97-77 QUEENS BLVD 9TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374
Mailing Address - Country:US
Mailing Address - Phone:718-267-2420
Mailing Address - Fax:
Practice Address - Street 1:97-77 QUEENS BLVD 9TH FLOOR
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-267-2420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-12
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0847471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03422093Medicaid