Thao Thi Phan, LMSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801114403 Issued in MI

Practice address

23100 Jefferson Ave
Saint Clair Shores, MI 48080-2756

Phone

(586) 335-2006

NPI assigned

May 24, 2022

Last updated

Jan 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Carolyn Phan Professional name

Medicare fee-for-service enrollment

Enrolled in MI

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

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bright Spot Counseling PLLCGroup PAC ID 4385995810, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bright Spot Counseling PLLC

  dba Bright Spot Counseling and EMDR Treatment Center

  • Multi-Specialty Clinic/Center
  • Farmington Hills, MI
  • NPI 1184105173

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1972241487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2146 PEACHTREE CT",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483241464",
            "telephone_number": "734-218-0922",
            "fax_number": "734-629-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23100 JEFFERSON AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802756",
            "telephone_number": "586-335-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "THAO",
        "middle_name": "THI",
        "credential": "LMSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-24",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "PHAN",
            "credential": "LMSW-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Elizabeth Perrotta, NP
• Perry Drug Stores Inc and Subsidiaries (Rite Aid Pharmacy 04500)
• Perry Drug Stores Inc and Subsidiaries (Rite Aid Pharmacy 04375)
• Richard T Perry, MD
• Sarah Petero
• David Philbrick, ATC
• Physicare Rehab, Inc.
• Alice Piatkowski, DDS
• Patrina G Pica-Kras, LPC
• Branislav Alexander Pichna, M.D.

• Clinical Social Worker in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.