VIENGKEO CHANTHALOTH- PHASOUK LCSW
NPI 1366920811
Social Worker - Clinical in Rockford, IL

Q: What is Viengkeo Chanthaloth- Phasouk's NPI number?

The NPI number for Viengkeo Chanthaloth- Phasouk is 1366920811. It was assigned to this individual provider in the NPPES registry on August 6, 2018. The provider is also known as Viengkeo Phasouk Lcsw.

Q: What is Viengkeo Chanthaloth- Phasouk's specialty?

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

Active since August 06, 2018PECOS EnrolledAccepts Medicare Assignment

2704 N MAIN ST, ROCKFORD, IL 61103(815) 391-1000(815) 815-7204 Get Directions Write a Review

NPPES record last updated: August 13, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 13, 2020, Aug 6, 2018 (2 updates tracked since 2018).

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About Viengkeo Chanthaloth- Phasouk Lcsw NPPES

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

VIENGKEO CHANTHALOTH- PHASOUK LCSW (NPI 1366920811) is an individual clinical provider in Rockford, Illinois, licensed in Illinois (149.022418) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1366920811

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameVIENGKEO CHANTHALOTH- PHASOUKCredential: LCSW

Location Address2704 N MAIN STRockford, IL 61103-3112

Mailing Address1021 N Mulford RdRockford, IL 61107-3877

Phone(815) 391-1000

Fax(815) 815-7204

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateAugust 6, 2018

Last NPPES UpdateAugust 13, 20202 updates tracked since enumeration

NPPES CertifiedAugust 13, 2020

✔ NPI 1366920811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in IL · 149.022418

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.

Also ListedCounselorTaxonomy 101Y00000X

2704 N MAIN ST, Rockford, IL 61103

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Other Names 1

Professional Name (2)Viengkeo Phasouk Lcsw

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include MercyCare Health Plans, Providence Health Plan, Quartz.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

Viengkeo Chanthaloth- Phasouk Lcsw 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 ID1153748447

PECOS Enrollment IDI20200901002564

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 61103 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 $54.80 – $168.44

Typical copayment $0.00 (range $13.70 – $42.11)

Most-billed visit code NA

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

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 20

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

LINDA HAUGEN

Counselor