MEDICARE: OLIVIA CLAIRE NGUYEN

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	101YM0800X	Mental Health Counselor	017427	NY

General Provider Information

NPI Number	:	1831886308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVIA CLAIRE NGUYEN

Provider Business Mailing Address
First Line	:	8 SHADOW VALE DR
Second Line	:
City	:	PENFIELD
State	:	NY
Zip	:	14526-1453
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2535 BRIGHTON HENRIETTA TOWN LINE RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14623-2711
Country	:	US
Telephone Number	:	585-201-8008
Fax Number	:

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

Provider Enumeration Date	:	04/24/2023
Last Update Date	:	01/19/2026

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Directions to “ OLIVIA CLAIRE NGUYEN ” Practice Location

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