Individual provider Active NPI

Truc Thanh Nguyen, M.S.

  • Clinical Psychologist
  • Saline, MI
National Provider Identifier
1023588787
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6361007316 Issued in MI
Practice address
760 Woodland Dr. East
Saline, MI 48176
Phone
(734) 219-9380
Fax
(734) 215-7090
NPI assigned
Nov 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301016844 MI
Clinical Psychologist 103TC0700X 6361007316 MI Primary

Addresses

Primary practice location

760 Woodland Dr. East
Saline, MI 48176

Mailing address

760 Woodland Dr East
Saline, MI 48176-1682
Phone (734) 219-9380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6301016844MIMDClinical Psychologist
6361007316MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rise Wellness Collaborative Clinical CurrentSince Mar 12, 2024 Accepting new patients

Locations

760 Woodland Dr
Saline, MI 48176
Phone (734) 219-9380

760 Woodland Dr
Ste D
Saline, MI 48176

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1023588787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 WOODLAND DR EAST",
            "city": "SALINE",
            "state": "MI",
            "postal_code": "481761682",
            "telephone_number": "734-219-9380",
            "fax_number": "734-215-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WOODLAND DR. EAST",
            "city": "SALINE",
            "state": "MI",
            "postal_code": "48176",
            "telephone_number": "734-219-9380",
            "fax_number": "734-215-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TRUC",
        "middle_name": "THANH",
        "name_prefix": "Miss",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301016844",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361007316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saline, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.