Provider Demographics
NPI:1053475400
Name:NGUYEN, TEYA THU (LPCC, LPC)
Entity type:Individual
Prefix:MS
First Name:TEYA
Middle Name:THU
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:LPCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5008 OAK MANOR BLVD
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-1661
Mailing Address - Country:US
Mailing Address - Phone:505-463-5022
Mailing Address - Fax:
Practice Address - Street 1:5522 LONE STAR PKWY STE 303
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-6722
Practice Address - Country:US
Practice Address - Phone:210-614-4990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM294566101YS0200X
TX88919101YP2500X
NMCCMH0151581101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health