Mosicrown Thao, MA, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC04576 Issued in MN

Practice address

2165 Woodlane Dr Ste 100
Woodbury, MN 55125-3055

Phone

(651) 283-3794

Fax

(651) 738-1881

NPI assigned

Sep 18, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Akv Psychological and Consulting Services LLCGroup PAC ID 6608932272, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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

• Akv Psychological and Consulting Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Woodbury, MN
  • NPI 1255572095
  Medicare reassignment Care Compare group NPD
• Be Well Psychological Services, LLC

  • Adult Mental Health Clinic/Center
  • Woodbury, MN
  • NPI 1609603471
  NPD

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1669209136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2165 WOODLANE DR STE 100",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253055",
            "telephone_number": "651-283-3794",
            "fax_number": "651-738-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 WOODLANE DR STE 100",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253055",
            "telephone_number": "651-283-3794",
            "fax_number": "651-738-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAO",
        "first_name": "MOSICROWN",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC04576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark K Thalacker, CNP
• Kayla Thalhuber
• Mai Der Thao
• Maylee Chang Thao, LPCC
• Michelle Suabcua Thao
• Shengyeng Thao
• Sophia Thao
• Umeng David Thao, MD
• Aimee Tharaldson
• Sunn Sunn H Thaw, M.D

• Mental Health Counselor in Woodbury, MN
• Providers in Woodbury, 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 Sep 18, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.