Amber Pham, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

44SC05924700 Issued in NJ

Practice address

2402 Browning Rd
Pennsauken, NJ 08110-1917

Phone

(267) 630-4688

NPI assigned

Jun 9, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Achieving Nirvana LLC

  • Clinical Social Worker
  • Pennsauken, NJ
  • NPI 1578173282
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1073138681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 W THOMPSON ST UNIT 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191214711",
            "telephone_number": "856-361-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 BROWNING RD",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081101917",
            "telephone_number": "267-630-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "AMBER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-09",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SC05924700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pennsauken Medical Center LLC
• Pennsauken Spine and Rehab
• Pennsuaken Family Practice, PC
• Jessica Bernice Perez, LCSW
• Lindsay Kay Pettorini, RN
• Patricia Pigliacelli, LPN
• Pinnacle Treatment Centers NJ-III, LLC (Delaware Valley Medical)
• Pinnacle Treatment Centers NJ-III, LLC (Delaware Valley Medical)
• Pinnacle Treatment Centers NJ-III, LLC (Delaware Valley Medical-Central)
• Praxis Technologies, Inc.

• Mental Health Counselor in Pennsauken, NJ
• Providers in Pennsauken, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.