Provider Demographics
NPI:1083448971
Name:THAICOUNSELOR P.C.
Entity type:Organization
Organization Name:THAICOUNSELOR P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:844-816-1777
Mailing Address - Street 1:1021 E LINCOLNWAY UNIT 768
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-4851
Mailing Address - Country:US
Mailing Address - Phone:844-816-1777
Mailing Address - Fax:866-473-2566
Practice Address - Street 1:825 9TH ST STE A
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-5246
Practice Address - Country:US
Practice Address - Phone:844-816-1777
Practice Address - Fax:866-473-2566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-02
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty