MEDICARE: HOANG CHAU CHRISTOPHER NGUYEN LCSW

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	104100000X	Social Worker	13046	KS
2	104100000X	Social Worker	39806	ID

General Provider Information

NPI Number	:	1811515372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOANG CHAU CHRISTOPHER NGUYEN LCSW

Provider Business Mailing Address
First Line	:	2800 N MIDWAY ST
Second Line	:
City	:	DERBY
State	:	KS
Zip	:	67037-9463
Country	:	US
Telephone Number	:	316-655-0208
Fax Number	:

Provider Business Practice Location Address
First Line	:	1221 N ROCK RD STE 100
Second Line	:
City	:	DERBY
State	:	KS
Zip	:	67037-3675
Country	:	US
Telephone Number	:	316-789-8511
Fax Number	:

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

Provider Enumeration Date	:	07/10/2020
Last Update Date	:	04/24/2023

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Directions to “ HOANG CHAU CHRISTOPHER NGUYEN LCSW” Practice Location

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