Individual provider · Type 1 NPI

Viengkeo Chanthaloth- Phasouk, LCSW

Clinical Social Worker · Rockford, IL

NPI number 1366920811 Active

Practice location

2704 N Main St
Rockford, IL 61103-3112

Call (815) 391-1000 Map

Fax (815) 815-7204

Mailing address

1021 N Mulford Rd
Rockford, IL 61107-3877

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XNone listed
Clinical Social Worker Primary 1041C0700X149.022418 (IL)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1366920811

Viengkeo Chanthaloth- Phasouk, LCSW's National Provider Identifier is 1366920811, issued on Aug 6, 2018. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Rockford, IL. The record was last updated on Aug 13, 2020.