Provider Demographics
NPI:1891136727
Name:NGUYEN, JENNY (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
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 1:5593 HIGHWAY 311
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2866
Mailing Address - Country:US
Mailing Address - Phone:985-876-2620
Mailing Address - Fax:
Practice Address - Street 1:28315 S FROST RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:LA
Practice Address - Zip Code:70754-2612
Practice Address - Country:US
Practice Address - Phone:225-283-1356
Practice Address - Fax:225-686-2962
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA115541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA11554OtherLCSW LICENSE