Active NPI
Lee Thao, LCSW
- Clinical Social Worker
- Sacramento, CA
National Provider Identifier
1063814960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 105606
- Practice address
- 2180 Harvard St Ste 210
Sacramento, CA 95815-3318 - Phone
- (855) 501-1004
- Fax
- (916) 567-3501
- NPI assigned
- Sep 23, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 105606 | CA | Primary |
Addresses
Primary practice location
2180 Harvard St Ste 210
Sacramento, CA 95815-3318
Mailing address
3835 N Freeway Blvd Ste 100
Sacramento, CA 95834-1954
Phone (916) 576-7900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230227000922 | CA | Order and Referring Only - Clinical Social Worker | 8325411143 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105606 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742169600000",
"number": "1063814960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3835 N FREEWAY BLVD STE 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958341954",
"telephone_number": "916-576-7900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2180 HARVARD ST STE 210",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958153318",
"telephone_number": "855-501-1004",
"fax_number": "916-567-3501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAO",
"first_name": "LEE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-23",
"last_updated": "2025-03-17",
"certification_date": "2025-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "105606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.