Provider Demographics
NPI:1750275145
Name:NGUYEN, THANG TAT (MS)
Entity type:Individual
Prefix:
First Name:THANG
Middle Name:TAT
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:TAT
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:1141 CANYON SHADOWS CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-1004
Mailing Address - Country:US
Mailing Address - Phone:336-862-0035
Mailing Address - Fax:
Practice Address - Street 1:15000 WESTON PKWY STE 165
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2118
Practice Address - Country:US
Practice Address - Phone:919-268-8054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRBT-23-271574106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician