Healthcare Provider Details

I. General information

NPI: 1487383543
Provider Name (Legal Business Name): ANYA GRACE NGUYEN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 E HIGGINS RD STE 140J
SCHAUMBURG IL
60173-4787
US

IV. Provider business mailing address

368 S JEWEL CT
PALATINE IL
60074-6826
US

V. Phone/Fax

Practice location:
  • Phone: 331-258-3857
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166.012231
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: