Provider Demographics
NPI:1346920436
Name:NGUYEN, CELESTIE BAO-HAN (LMSW)
Entity Type:Individual
Prefix:
First Name:CELESTIE
Middle Name:BAO-HAN
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 1:5301 DECKER LN APT 5301
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78724-5842
Mailing Address - Country:US
Mailing Address - Phone:832-643-5877
Mailing Address - Fax:
Practice Address - Street 1:2113 RIDDLE RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-1305
Practice Address - Country:US
Practice Address - Phone:832-643-5877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105831101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health