Provider Demographics
NPI:1932682556
Name:NGUYEN, ANN MARIE (LICSW)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 PRATT DR
Mailing Address - Street 2:
Mailing Address - City:WEST NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02465-1321
Mailing Address - Country:US
Mailing Address - Phone:401-338-5777
Mailing Address - Fax:
Practice Address - Street 1:37 PRATT DR
Practice Address - Street 2:
Practice Address - City:WEST NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02465-1321
Practice Address - Country:US
Practice Address - Phone:401-338-5777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1188981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical