Individual provider Active NPI

Xeng Ying Pha

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1518565126
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26614 Issued in MN
Practice address
1400 Queen Ave N
Minneapolis, MN 55411-2926
Phone
(651) 425-1614
Fax
(651) 204-2863
NPI assigned
Oct 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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 26614 MN Primary

Addresses

Primary practice location

1400 Queen Ave N
Minneapolis, MN 55411-2926

Mailing address

1400 Queen Ave N
Minneapolis, MN 55411-2926
Phone (651) 425-1614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20241104000193 MN Practitioner - Clinical Social Worker 7911430608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1400 Queen Ave N
Minneapolis, MN 55411-2926
Phone (651) 425-1614

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Diverse Mental Health Response LLC Clinical CurrentSince Jul 30, 2024 Accepting new patients
Diverse Health and Social Services LLC Clinical Current Accepting new patients
Washburn Center for Children PastSince Oct 1, 2020 Accepting new patients

Organizations & group practices 3

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": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1518565126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 QUEEN AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554112926",
            "telephone_number": "651-425-1614",
            "fax_number": "651-204-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 QUEEN AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554112926",
            "telephone_number": "651-425-1614",
            "fax_number": "651-204-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHA",
        "first_name": "XENG",
        "middle_name": "YING",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-15",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.