Provider Demographics
NPI:1952566747
Name:TRUE THAO COUNSELING SERVICES
Entity Type:Organization
Organization Name:TRUE THAO COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TRUE
Authorized Official - Middle Name:JACOB
Authorized Official - Last Name:THAO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:651-247-3276
Mailing Address - Street 1:796 7TH ST E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-5015
Mailing Address - Country:US
Mailing Address - Phone:651-247-3276
Mailing Address - Fax:
Practice Address - Street 1:796 7TH ST E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-5015
Practice Address - Country:US
Practice Address - Phone:651-247-3276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN11769251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1457536278Medicaid