Provider Demographics
NPI:1871862516
Name:LUU, BAC THI (LCSW)
Entity Type:Individual
Prefix:
First Name:BAC
Middle Name:THI
Last Name:LUU
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W 1ST ST
Mailing Address - Street 2:6TH FLOOR, RM 630
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-4112
Mailing Address - Country:US
Mailing Address - Phone:213-798-5077
Mailing Address - Fax:
Practice Address - Street 1:100 W 1ST ST
Practice Address - Street 2:6TH FLOOR, RM 630
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-4112
Practice Address - Country:US
Practice Address - Phone:213-996-1347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-27
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 210611041C0700X
CALCS289741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical