Provider Demographics
NPI:1811515372
Name:NGUYEN, HOANG CHAU CHRISTOPHER (LCSW)
Entity type:Individual
Prefix:
First Name:HOANG CHAU
Middle Name:CHRISTOPHER
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 N MIDWAY ST
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-9463
Mailing Address - Country:US
Mailing Address - Phone:316-655-0208
Mailing Address - Fax:
Practice Address - Street 1:1221 N ROCK RD STE 100
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-3675
Practice Address - Country:US
Practice Address - Phone:316-789-8511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13046104100000X
ID39806104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker