Provider Demographics
NPI:1194556050
Name:DO-NGUYEN, KEVIN KHOA (LMSW)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:KHOA
Last Name:DO-NGUYEN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 TAYLOR DR
Mailing Address - Street 2:
Mailing Address - City:FATE
Mailing Address - State:TX
Mailing Address - Zip Code:75087-0539
Mailing Address - Country:US
Mailing Address - Phone:682-230-4301
Mailing Address - Fax:
Practice Address - Street 1:930 W RALPH HALL PKWY STE 114
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6664
Practice Address - Country:US
Practice Address - Phone:682-230-4301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113694101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health