Provider Demographics
NPI:1720593700
Name:NGUYEN, BRIAN
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 JEFFERSON ST
Mailing Address - Street 2:STE 2C
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24504-1724
Mailing Address - Country:US
Mailing Address - Phone:609-272-8580
Mailing Address - Fax:609-645-7343
Practice Address - Street 1:7 LINCOLN HWY
Practice Address - Street 2:STE 224
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3965
Practice Address - Country:US
Practice Address - Phone:732-479-4763
Practice Address - Fax:617-807-0958
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health