Individual provider Active NPI

Naree Thao, MA, LPC

  • Professional Counselor
  • Appleton, WI
National Provider Identifier
1770973570
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6473-125 Issued in WI
Practice address
1835 E Edgewood Dr Ste 105-532
Appleton, WI 54913-9407
Phone
(920) 204-6585
NPI assigned
Jan 31, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6473-125 WI Primary

Addresses

Primary practice location

1835 E Edgewood Dr Ste 105-532
Appleton, WI 54913-9407

Mailing address

1835 E Edgewood Dr Ste 105-532
Appleton, WI 54913-9407
Phone (920) 204-6585

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
I20240508003838 WI Practitioner - Mental Health Counselor 0840631800 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6473-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
County of Outagamie CurrentSince Mar 27, 2024 Accepting new patients

Locations

320 S Walnut St
Appleton, WI 54911
Phone (920) 832-1624

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": "1422662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1770973570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 E EDGEWOOD DR STE 105-532",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139407",
            "telephone_number": "920-204-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 E EDGEWOOD DR STE 105-532",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139407",
            "telephone_number": "920-204-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAO",
        "first_name": "NAREE",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-31",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6473-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.