Provider Demographics
NPI:1598074239
Name:NGUYEN, CATHERINE LAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:LAN
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1669 THOMASTON AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06704-1026
Mailing Address - Country:US
Mailing Address - Phone:203-759-3505
Mailing Address - Fax:203-759-3529
Practice Address - Street 1:1669 THOMASTON AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06704-1026
Practice Address - Country:US
Practice Address - Phone:203-759-3505
Practice Address - Fax:203-759-3529
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0088051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical