Provider Demographics
NPI:1881856698
Name:NGUYEN, THINH (LCSW-C)
Entity Type:Individual
Prefix:
First Name:THINH
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4419 FALLS RD STE E
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-1296
Mailing Address - Country:US
Mailing Address - Phone:410-262-9894
Mailing Address - Fax:
Practice Address - Street 1:4419 FALLS RD STE E
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-1296
Practice Address - Country:US
Practice Address - Phone:410-262-9894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD174331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0629770000Medicaid