Vyvian Phan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SWB-2023-0980 Issued in NM

Practice address

9201 Montgomery Blvd NE Ste a
Albuquerque, NM 87111-2468

Phone

(505) 702-9080

NPI assigned

Sep 29, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Movement Psychotherapy Services LLC

  • Community/Behavioral Health Agency
  • Albuquerque, NM
  • NPI 1942080114

  NM

  Medicare reassignment NPD Authorized official
• Faith Works Counseling LLC

  • Community/Behavioral Health Agency
  • Albuquerque, NM
  • NPI 1073045688

  NM

  Medicare reassignment NPD
• Kintsugi Behavioral Health LLC

  • Community/Behavioral Health Agency
  • Corrales, NM
  • NPI 1568259091

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781913600000",
    "number": "1255840575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 SMARTY JONES ST SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871232398",
            "telephone_number": "505-702-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 MONTGOMERY BLVD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112468",
            "telephone_number": "505-702-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "VYVIAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-29",
        "last_updated": "2026-06-20",
        "certification_date": "2026-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2023-0980",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "115372",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Phan
• Loan Phan, PHD
• Minh Phan
• Nhut Minh Phan, PMSW
• Sheshanna Nguyen Phuong Khanh Phan, DO
• Carol Phares, OTR
• Pharmacy Capital LLC
• Pharmacy on the Bosque LLC
• Pharmascript Inc
• Pharmcare USA of New Mexico LLC

• All providers in Albuquerque, NM
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2026; 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.