KHAMPHADY KEOVONGSA (NPI# 1194125625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194125625 |
| Entity Type | Individual |
| Full Name | KHAMPHADY KEOVONGSA |
| Credential | LCSW |
| Practice Address |
3970 S 700 E #17 Salt Lake City UT 84107-2191 |
| Mailing Address |
2 Avon Street #6 Cambridge MA 02138 |
| Practice Telephone | 8016399544 |
| Practice Fax Number | 8012634333 |
| Mailing Telephone | 9167172448 |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2017-07-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
9455497-3502 | UT | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
9455497-3501 | UT | Behavioral Health & Social Service Providers |
| Street Address |
3970 S 700 E #17 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84107-2191 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144206707 | Barbara T. Liebroder | Psychologist | 3970 S 700 E, Ste. 12, Salt Lake City, UT 84107-2191 | 2005-12-15 |
| 1538696000 | Compass Counseling and Consulting | Counselor | 3970 S 700 E, Ste 17, Salt Lake City, UT 84107-2191 | 2017-05-16 |
| 1184088247 | Matthew Forbes | Social Worker | 3970 S 700 E, Suite 17, Salt Lake City, UT 84107-2191 | 2016-04-05 |
| 1235512260 | Tracy Golden | Counselor | 3970 S 700 E, #17, Salt Lake City, UT 84107-2191 | 2015-07-08 |
| 1861888695 | Natalie Palmer-sheppard | Counselor | 3970 S 700 E, Suite 17, Salt Lake City, UT 84107-2191 | 2015-04-08 |
| 1932538519 | Van Evans | Social Worker | 3970 S 700 E, Suite #17, Salt Lake City, UT 84107-2191 | 2013-11-05 |
| 1609196781 | Timothy James Weymann | Social Worker | 3970 S 700 E, Suite 17, Salt Lake City, UT 84107-2191 | 2010-06-10 |
| 1356669360 | Compass Counseling and Consulting | Community/Behavioral Health | 3970 S 700 E, Old Farm Professional Plaza #17, Salt Lake City, UT 84107-2191 | 2010-05-14 |
| 1700011954 | Erica A. Faircloth, M.d., P.C. | Obstetrics & Gynecology | 3970 S 700 E, Suite 14, Salt Lake City, UT 84107-2191 | 2009-05-18 |
| 1982839130 | Spencer P. Barney, M.d., P.C. | Obstetrics & Gynecology | 3970 S 700 E, Suite 14, Salt Lake City, UT 84107-2191 | 2009-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606763 | Eric Jeffrey Hales | Social Worker | 352 S Denver St Ste 350, Salt Lake City, UT 84111-3059 | 2020-10-14 |
| 1700490067 | Open Arms Youth and Adult Services | Social Worker | 3007 S West Temple Ste J, Salt Lake City, UT 84115-6701 | 2020-09-03 |
| 1275147019 | Libby Rae Hughes | Social Worker | 1170 S Foothill Dr Apt 323, Salt Lake City, UT 84108-1955 | 2020-08-31 |
| 1881206910 | Christine Madden | Social Worker | 699 E South Temple Ste 300a, Salt Lake City, UT 84102-1188 | 2020-08-19 |
| 1003428566 | Laura Marie Baumgart | Social Worker | 1390 S 1100 E Ste 204, Salt Lake City, UT 84105-2463 | 2020-08-17 |
| 1851901193 | Angelique Colemere | Social Worker | 1399 S 700 E Ste 16, Salt Lake City, UT 84105-2170 | 2020-08-02 |
| 1871102095 | Aimee Hadfield | Social Worker | Hearten House, 314 W. Broadway #222, Salt Lake City, UT 84109 | 2020-07-23 |
| 1619586856 | Layne Gerry Daybell | Social Worker | 136 E South Temple, Salt Lake City, UT 84111-1180 | 2020-07-23 |
| 1043829328 | Christopher Wesley Pace | Social Worker | 2000 Circle of Hope Dr Rm 2840, Salt Lake City, UT 84112-5550 | 2020-07-23 |
| 1962028795 | Amy Lynn Horyna | Social Worker | 1950 Circle of Hope Dr Rm 2935, Salt Lake City, UT 84112-5500 | 2020-06-17 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84107 |
Please comment or provide details below to improve the information on KHAMPHADY KEOVONGSA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.