MOSICROWN THAO (MA, LPCC) – Mental Health Counselor, NPI 1669209136

MOSICROWN THAO (MA, LPCC) is a healthcare provider. based in Woodbury, Minnesota. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA, LPCC. They hold a License No. CC04576 (MN). The NPI Number for MOSICROWN THAO (MA, LPCC) is 1669209136

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
MOSICROWN THAO (MA, LPCC)
NPI
1669209136
Phone
(651) 283-3794
Address
2165 WOODLANE DR STE 100
Enumeration Date
18 September 2024
Last Update Date
18 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6512833794
Graduation Year
2016 (10 years ago)
PAC ID
5991231946
Group Practice PAC ID
6608932272
Professional Enrollment ID
I20241213001065
Address ID
MN551253055WO2165XDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

1,813 MENTAL HEALTH COUNSELOR in MN

Provider Addresses for MOSICROWN THAO (MA, LPCC)

  • 2165 WOODLANE DR STE 100

    WOODBURY, MN 551253055

    Phone: (651) 283-3794

    Fax: (651) 738-1881

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-12-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241213001065IMental Health CounselorMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55125)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6608932272View full group profile
NameSpecialtyState
Clinical Social WorkerMN
Marriage And Family TherapistMN
Clinical Social WorkerMN
Clinical PsychologistMN

Reviews

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Frequently asked questions

Is MOSICROWN THAO (MA, LPCC) listed with a National Provider Identifier?
Yes — MOSICROWN THAO (MA, LPCC) has NPI 1669209136 on file in the registry.
Active or inactive — what applies to MOSICROWN THAO (MA, LPCC)?
You should see MOSICROWN THAO (MA, LPCC) as active in CMS-hosted NPPES data.
What kind of doctor is MOSICROWN THAO (MA, LPCC)?
MOSICROWN THAO (MA, LPCC) is associated with Mental Health Counselor in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for MOSICROWN THAO (MA, LPCC)?
Travel planning: use Woodbury, Minnesota as the reference point for MOSICROWN THAO (MA, LPCC), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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