Quang Pho

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LICSW127903 Issued in MA

Practice address

74 Florence St Apt 2
Somerville, MA 02145-3430

Phone

(857) 626-6936

NPI assigned

Aug 9, 2018

Sex

Male

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

Enrolled in MA

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brookline Community Mental Health Center IncGroup PAC ID 9032181433, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Brookline Community Mental Health Center Inc.

  • Community/Behavioral Health Agency
  • Brookline, MA
  • NPI 1881610244
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1417436585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 BROADWAY UNIT 45521",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021454522",
            "telephone_number": "857-626-6936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 FLORENCE ST APT 2",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021453430",
            "telephone_number": "857-626-6936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHO",
        "first_name": "QUANG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-09",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW127903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elise Pflaumer
• Patthrarawalai Phichalai, M.D., M.P.H.
• Carmen Phillips
• Michael Phillips Jr.
• Nicole Phillips, MSW, LICSW
• Joseph Allen Piekos, RPH
• Marygrace Pier
• Florence Pierre Louis
• Marie Laurence Pierre-Louis, BA/LSW
• Amose Pierre

• Clinical Social Worker in Somerville, MA
• Providers in Somerville, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.