Provider Demographics
NPI:1912759283
Name:NGUYEN, ALEX MICHAEL (PLMHP)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:MICHAEL
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19887 L ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-3836
Mailing Address - Country:US
Mailing Address - Phone:402-719-4424
Mailing Address - Fax:
Practice Address - Street 1:3803 N 153RD ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-5175
Practice Address - Country:US
Practice Address - Phone:402-674-6957
Practice Address - Fax:402-939-0524
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13838101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health