NPIMap

Individual provider Active NPI

Nhu-Tam Pham Villar, MA LCADC NCC

  • Addiction (Substance Use Disorder) Counselor
  • Las Vegas, NV
National Provider Identifier
1386762664
Registry record updated Sep 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1146 Issued in NV
Practice address
6375 W Charleston Blvd
Ste a-172
Las Vegas, NV 89146-1139
Phone
(702) 877-0684
Fax
(702) 877-2108
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 217655 NV
Addiction (Substance Use Disorder) Counselor 101YA0400X 1146 NV Primary

Addresses

Primary practice location

6375 W Charleston Blvd
Ste a-172
Las Vegas, NV 89146-1139

Mailing address

6375 W Charleston Blvd
172
Las Vegas, NV 89146-1139
Phone (702) 877-0684

Other identifiers 5

IdentifierTypeStateIssuer
NCC 217655OtherNVNV NATIOANL BOARD
1146 LCDCOtherNVLICENSE
100500484MedicaidNV
1146 LADCOtherNVLADC LICENSE
3015OtherNVLICENSE

Other names 1

  • Mrs. Nhu-Tam Pham Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
217655NVMDCounselor
1146NVMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Medschool Associates South Addiction (Substance Use Disorder) Past Accepting new patients

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252972800000",
    "number": "1386762664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6375 W CHARLESTON BLVD",
            "address_2": "172",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461139",
            "telephone_number": "702-877-0684",
            "fax_number": "702-877-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6375 W CHARLESTON BLVD",
            "address_2": "STE A-172",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461139",
            "telephone_number": "702-877-0684",
            "fax_number": "702-877-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAR",
        "first_name": "NHU-TAM",
        "middle_name": "PHAM",
        "name_prefix": "Ms.",
        "credential": "MA LCADC NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2009-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NV",
            "license": "217655",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "1146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV NATIOANL BOARD",
            "identifier": "NCC 217655",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1146 LCDC",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100500484",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LADC LICENSE",
            "identifier": "1146 LADC",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "3015",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NHU-TAM",
            "last_name": "PHAM",
            "prefix": "MRS.",
            "credential": "MA LADC NCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; 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.