Provider Demographics
NPI:1710939632
Name:NGUYEN, TAMMY THAO (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:THAO
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 1:81 FORT GREENE PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-1218
Mailing Address - Country:US
Mailing Address - Phone:917-664-7082
Mailing Address - Fax:718-613-4381
Practice Address - Street 1:55 CHRYSTIE ST
Practice Address - Street 2:SUITE 407
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-5042
Practice Address - Country:US
Practice Address - Phone:917-664-7082
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0723951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical