Individual provider Active NPI

Kayoua Thao

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1730627977
Registry record updated Feb 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7158-C Issued in NV
Practice address
6655 W Sahara Ave
Ste D110
Las Vegas, NV 89146-0842
Phone
(702) 365-0600
Fax
(702) 365-0602
NPI assigned
Feb 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2017

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 7158-C NV Primary

Addresses

Primary practice location

6655 W Sahara Ave
Ste D110
Las Vegas, NV 89146-0842

Mailing address

2362 N Green Valley Pkwy
Apt 93
Henderson, NV 89014-3661
Phone (734) 709-3141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230124003343 CA Practitioner - Clinical Social Worker 3870870348 Reassigns benefits to 1 organization
I20231228002510 WA Practitioner - Clinical Social Worker 3870870348 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7158-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
KCT Psychotherapy & Consulting Current Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Oct 24, 2023 Accepting new patients
Grow Healthcare Group PC Clinical CurrentSince Dec 20, 2022 Accepting new patients
I.C.a.N. Family Services LLC PastSince Aug 18, 2019 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

3753 Howard Hughes Pkwy
Ste 200
Las Vegas, NV 89169
Phone (702) 919-6580

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1730627977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2362 N GREEN VALLEY PKWY",
            "address_2": "APT 93",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890143661",
            "telephone_number": "734-709-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 W SAHARA AVE",
            "address_2": "STE D110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891460842",
            "telephone_number": "702-365-0600",
            "fax_number": "702-365-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAO",
        "first_name": "KAYOUA",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "7158-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.