Ryan O Theisen, LADC, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5099 Issued in MN

Practice address

2950 Xenium LN N Ste 130
Plymouth, MN 55441-2623

Phone

(612) 564-3535

Fax

(763) 545-8150

NPI assigned

Jul 15, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1752537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1376434597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 XENIUM LN N STE 130",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412623",
            "telephone_number": "612-564-3535",
            "fax_number": "763-545-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 XENIUM LN N STE 130",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412623",
            "telephone_number": "612-564-3535",
            "fax_number": "763-545-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEISEN",
        "first_name": "RYAN",
        "middle_name": "O",
        "credential": "LADC, LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "306571",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "5099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kathleen Thomason, OTR/L

• Mental Health Counselor in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.