Healthcare Provider Details

I. General information

NPI: 1831019462
Provider Name (Legal Business Name): AMY NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 ROLLING HILLS DR
NEWTON KS
67114-4015
US

IV. Provider business mailing address

404 ROLLING HILLS DR
NEWTON KS
67114-4015
US

V. Phone/Fax

Practice location:
  • Phone: 316-612-3439
  • Fax: 316-612-3439
Mailing address:
  • Phone: 316-612-3439
  • Fax: 316-612-3439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number05481
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: