Individual provider Active NPI

Lyda Thao, LCSW

  • Clinical Social Worker
  • Madison, WI
National Provider Identifier
1770101768
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11193-123 Issued in WI
Practice address
815 Forward Dr
Madison, WI 53711-2443
Phone
(608) 268-6530
Fax
(608) 709-1744
NPI assigned
Jul 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X 11193-123 WI Primary

Addresses

Primary practice location

815 Forward Dr
Madison, WI 53711-2443

Mailing address

815 Forward Drive
Madison, WI 53711-2443
Phone (608) 268-6530

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lyda.thao@journeymhc.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20230609001221 WI Practitioner - Clinical Social Worker 3476910217

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

815 Forward Dr
Madison, WI 53711-2443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11193-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Anesis Center for Marriage and Family Therapy Clinical CurrentSince Jun 5, 2025 Accepting new patients

Locations

815 Forward Dr
Madison, WI 53711
Phone (608) 268-6530

2801 International Ln
Ste 207
Madison, WI 53704
Phone (608) 228-4610

Organizations & group practices 1

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": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1770101768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 FORWARD DRIVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112443",
            "telephone_number": "608-268-6530",
            "fax_number": "608-709-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 FORWARD DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112443",
            "telephone_number": "608-268-6530",
            "fax_number": "608-709-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAO",
        "first_name": "LYDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11193-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lyda.thao@journeymhc.org",
            "affiliation": "Y",
            "address_1": "25 Kessel Ct Ste 105",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537116227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.