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General NPI Number Information
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NPI Number | 1265235196
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Entity Type | Individual
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Provider Name | SAMANTHA VERONICA NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 655 W IRVING PARK RD APT 4304
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City | CHICAGO
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State | IL
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Zip | 60613-6300
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Country | US
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Telephone | 773-304-8723
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Fax |
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Provider Business Mailing Address
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Address Line | 2743 N AVERS AVE
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City | CHICAGO
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State | IL
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Zip | 60647-1017
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Country | US
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Telephone | 773-971-9080
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178017805
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License Number State | IL
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