Phong Pham, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1617 Issued in MA

Practice address

125 Cambridgepark Dr Ste 301
Cambridge, MA 02140-2392

Phone

(857) 919-4493

NPI assigned

Jul 15, 2014

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Stars to Success, LLC

  • Behavior Analyst
  • Cambridge, MA
  • NPI 1538774088
  NPD Authorized official

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1235546979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 CAMBRIDGEPARK DR STE 301",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021402392",
            "telephone_number": "857-919-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CAMBRIDGEPARK DR STE 301",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021402392",
            "telephone_number": "857-919-4493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Paul Revere Rd",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "MA",
            "postal_code": "024216635",
            "country_code": "US",
            "telephone_number": "857-919-4493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "PHONG",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "1617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Starr Pfister, BS
• Daniel Pforte, LSW
• Virginia A Phakos, MSW, LICSW
• An Pham, BSW
• Anh Mai Pham, BS
• Jenica Phelps, LCSW
• Anthony Andrew Philippakis, M.D., PHD
• Binu Philips, M.D.
• Aleksandra Panov Phillips, M.D.
• Ariel Ingrid Aino Phillips, ED.D.

• Behavior Analyst in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Behavior Analyst in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.