Healthcare Provider Details

I. General information

NPI: 1619069895
Provider Name (Legal Business Name): NGOC THUY HOANG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 02/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VA MEDICAL CENTER/NHCU-2 650 E INDIAN SCHOOL RD
PHOENIX AZ
85012
US

IV. Provider business mailing address

650 E INDIAN SCHOOL RD PHOENIX VA HEALTHCARE SYSTEM
PHOENIX AZ
85012-1839
US

V. Phone/Fax

Practice location:
  • Phone: 602-277-5551
  • Fax: 602-212-2111
Mailing address:
  • Phone: 602-277-5551
  • Fax: 602-212-2111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW 10940
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: