Chanthaloth- Phasouk, Viengkeo

Chanthaloth- Phasouk, Viengkeo is an individual health care provider with primary practice located at 2704 N Main St , Rockford IL 61103-3112. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Chanthaloth- Phasouk, Viengkeo can be contacted via phone (815) 391-1000.

Contact Information

Primary practice address
2704 N Main St Rockford IL 61103-3112
Phone: (815) 391-1000
Fax: (815) 815-7204
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149.022418 Illinois

Profile Details

NPI number 1366920811
LBN Legal business name Chanthaloth- Phasouk, Viengkeo
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 6th, 2018
Last updated Aug 13th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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