Individual provider Active NPI

Kenneth Richard Thau, M.S.W., J.D.

  • Clinical Social Worker
  • Bristow, VA
National Provider Identifier
1013980523
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904003262 Issued in VA
Practice address
7969 Sequoia Park Way
Bristow, VA 20136-1286
Phone
(202) 320-5322
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 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 0904003262 VA Primary

Addresses

Primary practice location

7969 Sequoia Park Way
Bristow, VA 20136-1286

Mailing address

PO Box 807
Bristow, VA 20136-0807
Phone (202) 320-5322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Juris Doctor

State licenses

LicenseStateTypeSpecialty
0904003262VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth R Thau Clinical CurrentSince Jun 28, 2020 Accepting new patients
Greater Baltimore Counseling Center, LLC Clinical PastSince Feb 1, 1996 Accepting new patients
Oasis the Mental Health Center, LLC PastSince Jan 29, 2023 Accepting new patients
Prince William Family Counseling, P.C. Past Accepting new patients
Insight Psychological Services, PLLC Past Accepting new patients

Locations

4405 East West Hwy
Ste 407
Bethesda, MD 20814
Phone (202) 320-5322

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1013980523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 807",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201360807",
            "telephone_number": "202-320-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7969 SEQUOIA PARK WAY",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201361286",
            "telephone_number": "202-320-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAU",
        "first_name": "KENNETH",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "M.S.W., J.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904003262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristow, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.