KHAMPHADY KEOVONGSA LICSW
NPI 1194125625
Social Worker - Clinical in Arlington, MA

Q: What is Khamphady Keovongsa's NPI number?

The NPI number for Khamphady Keovongsa is 1194125625. It was assigned to this individual provider in the NPPES registry on September 3, 2014.

Q: What is Khamphady Keovongsa's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since September 03, 2014PECOS EnrolledAccepts Medicare Assignment

30 STANDISH RD, ARLINGTON, MA 02476(781) 999-4975(801) 263-4333 Get Directions Write a Review

NPPES record last updated: September 21, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 26, 2017, Mar 28, 2016 (2 updates tracked since 2016).

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About Khamphady Keovongsa Licsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KHAMPHADY KEOVONGSA LICSW (NPI 1194125625) is an individual clinical provider in Arlington, Massachusetts, licensed in Utah (9455497-3501) and active in the NPI registry since September 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1194125625

Entity TypeIndividualMale

Primary Taxonomy1041C0700X

Provider Legal NameKHAMPHADY KEOVONGSACredential: LICSW

Location Address30 STANDISH RDArlington, MA 02476-7069

Mailing Address30 Standish RdArlington, MA 02476-7069 · (781) 999-4975 · Fax (617) 812-1596

Phone(781) 999-4975

Fax(801) 263-4333

Sole ProprietorYes

Medical School CMSOtherGraduated 2015

Enumeration DateSeptember 3, 2014

Last NPPES UpdateSeptember 21, 20232 updates tracked since enumeration

NPPES CertifiedSeptember 21, 2023

✔ NPI 1194125625 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

Licenses✔ Licensed in UT · 9455497-3501✔ Licensed in UT · 9455497-3502

Definition

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.

30 STANDISH RD, Arlington, MA 02476

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Khamphady Keovongsa Licsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6305144338

PECOS Enrollment IDI20231011003180

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02476 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $63.72 – $189.86

Typical copayment $0.00 (range $15.93 – $47.46)

Most-billed visit code NA

Established Patient

$78.84 typical visit price

range $21.07 – $155.29

Typical copayment $19.71 (range $5.26 – $38.82)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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Social Worker (Clinical)