Provider Demographics
NPI:1083598098
Name:NGUYEN-PEPPER, MINA H (PHD, LMSW)
Entity type:Individual
Prefix:DR
First Name:MINA
Middle Name:H
Last Name:NGUYEN-PEPPER
Suffix:
Gender:F
Credentials:PHD, LMSW
Other - Prefix:
Other - First Name:MINA
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:88 SAINT NICHOLAS AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-2926
Mailing Address - Country:US
Mailing Address - Phone:646-676-2747
Mailing Address - Fax:
Practice Address - Street 1:88 SAINT NICHOLAS AVE APT 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-2926
Practice Address - Country:US
Practice Address - Phone:646-676-2747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY126437011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical