Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Khamphady Keovongsa, LICSW

Individual provider Clinical Social Worker · NPI 1194125625

Khamphady Keovongsa, LICSW is a Clinical Social Worker in Arlington, Massachusetts. Qualified in 2015, 11 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
11
Licensed in
UT
In the registry since
2014
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

30 Standish Rd
Arlington, MA 02476-7069
Phone: (781) 999-4975
Fax: (801) 263-4333
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 9455497-3501 (UT)
Clinical Social Worker Taxonomy 1041C0700X · Licence 9455497-3502 (UT)

Record details

NPI number1194125625
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorYes
NPI enumeratedSeptember 3, 2014
Last updated in NPPESSeptember 21, 2023
Certification dateSeptember 21, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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