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NPI Code Detail

MEDICARE: MS. TEYA THU NGUYEN LPCC, LPC

MEDICARE: MS. TEYA THU NGUYEN LPCC, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YS0200XSchool Counselor294566NM
2101YP2500XProfessional Counselor88919TX
3101YM0800XMental Health CounselorCCMH0151581NM

General Provider Information

NPI Number : 1053475400
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TEYA THU NGUYEN LPCC, LPC
Provider Business Mailing Address
First Line : 5008 OAK MANOR BLVD
Second Line :
City : BAY CITY
State : TX
Zip : 77414-1661
Country : US
Telephone Number : 505-463-5022
Fax Number :
Provider Business Practice Location Address
First Line : 5522 LONE STAR PKWY STE 303
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78253-6722
Country : US
Telephone Number : 210-614-4990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 07/30/2022

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