Individual provider Active NPI

Christina Pham

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1376937102
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L10924 Issued in OR
Practice address
2505 SE 11TH Ave Ste 216
Portland, OR 97202-1062
Phone
(971) 231-5163
Fax
(971) 375-4429
NPI assigned
Mar 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L10924 OR Primary

Addresses

Primary practice location

2505 SE 11TH Ave Ste 216
Portland, OR 97202-1062

Mailing address

2505 SE 11TH Ave Ste 216
Portland, OR 97202-1062
Phone (971) 231-5163

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vypham@tapcounselingllc.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20220331002948 OR Order and Referring Only - Clinical Social Worker 0244626133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L10924ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tap Counseling LLC Clinical CurrentSince Jun 1, 2022 Accepting new patients

Locations

10424 SE Cherry Blossom Dr
Ste F2
Portland, OR 97216

2505 SE 11th Ave
Ste 216
Portland, OR 97202
Phone (650) 254-6723

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1376937102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 SE 11TH AVE STE 216",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021062",
            "telephone_number": "971-231-5163",
            "fax_number": "971-375-4429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 SE 11TH AVE STE 216",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021062",
            "telephone_number": "971-231-5163",
            "fax_number": "971-375-4429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-18",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vypham@tapcounselingllc.com",
            "affiliation": "N",
            "endpointDescription": "Registered Agent",
            "address_1": "5305 River Rd N Ste B",
            "city": "Keizer",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973035324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.