Soukthanome Thammavong, LICSW
NPI 1164986246ActiveIndividual· Social Worker, Clinical· Columbia Heights, MN
Social Worker, Clinical (LICSW) in Columbia Heights, Minnesota, with an NPI issued in January 2019. Medicare paid $900.50 for services to 11 patients in 2024.
Overview
| NPI | 1164986246 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LICSW |
| Sole proprietor | No |
| NPI issued | Jan 23, 2019 |
| Last updated in NPPES | Apr 25, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (MN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 11 |
|---|---|
| Services billed | 11 across 1 procedure code |
| Paid by Medicare | $900.50 |
Education and affiliations
| Graduation year | 2008 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Other clinical social workers in Columbia Heights
- 1679145122
- 1659090033
- 1477286722
- 1366384414