Provider Demographics
NPI:1447684352
Name:NEUMAN, MY PHAN NGAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MY PHAN
Middle Name:NGAN
Last Name:NEUMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEPHON
Other - Middle Name:N
Other - Last Name:NEUMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:40 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-3361
Mailing Address - Country:US
Mailing Address - Phone:978-534-6116
Mailing Address - Fax:
Practice Address - Street 1:40 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-3361
Practice Address - Country:US
Practice Address - Phone:978-534-6116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2016-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218859104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker