Provider Demographics
NPI:1073232278
Name:NGUYEN, PHUONGCHAU THI (LMSW)
Entity Type:Individual
Prefix:MS
First Name:PHUONGCHAU
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W 31ST ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-7511
Mailing Address - Country:US
Mailing Address - Phone:832-646-8789
Mailing Address - Fax:
Practice Address - Street 1:3131 EASTSIDE ST STE 415
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-1919
Practice Address - Country:US
Practice Address - Phone:832-560-9698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54265101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health