Provider Demographics
NPI:1639765365
Name:HOANG, TOMMY (LCSW)
Entity Type:Individual
Prefix:
First Name:TOMMY
Middle Name:
Last Name:HOANG
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2285 MINT JULEP CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-4540
Mailing Address - Country:US
Mailing Address - Phone:678-790-2231
Mailing Address - Fax:
Practice Address - Street 1:2285 MINT JULEP CT
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-4540
Practice Address - Country:US
Practice Address - Phone:678-790-2231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty