MEDICARE: MR. NATHAN TRUONG

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
1	106H00000X	Marriage & Family Therapist		CT

General Provider Information

NPI Number	:	1205712163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NATHAN TRUONG

Provider Business Mailing Address
First Line	:	25 CANDEE HILL RD
Second Line	:
City	:	WATERTOWN
State	:	CT
Zip	:	06795-3101
Country	:	US
Telephone Number	:	203-759-8083
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 CANDEE HILL RD
Second Line	:
City	:	WATERTOWN
State	:	CT
Zip	:	06795-3101
Country	:	US
Telephone Number	:	203-759-8083
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2025
Last Update Date	:	01/20/2026

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Directions to “ MR. NATHAN TRUONG ” Practice Location

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