Provider Demographics
NPI:1508483439
Name:KENNETH R THAU
Entity Type:Organization
Organization Name:KENNETH R THAU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:THAU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:202-320-5322
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-0010
Mailing Address - Country:US
Mailing Address - Phone:202-320-5322
Mailing Address - Fax:
Practice Address - Street 1:4405 E WEST HWY STE 407
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4535
Practice Address - Country:US
Practice Address - Phone:202-320-5322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty