Provider Demographics
NPI:1336678226
Name:NGUYEN, THUYDY N (MS, LMFT)
Entity type:Individual
Prefix:
First Name:THUYDY
Middle Name:N
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 WISEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76105-2961
Mailing Address - Country:US
Mailing Address - Phone:682-337-9494
Mailing Address - Fax:866-635-2213
Practice Address - Street 1:2301 PARK AVE STE 205
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-5558
Practice Address - Country:US
Practice Address - Phone:904-592-7298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-05
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205626106H00000X
VT100.0134184106H00000X
DEMI0000007106H00000X
FLMT4364106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist