Individual
LYDA THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
815 FORWARD DR, MADISON, WI 53711-2443
(608) 268-6530
(608) 709-1744
Mailing address
815 FORWARD DRIVE, MADISON, WI 53711-2443
(608) 268-6530
(608) 709-1744
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11193
WI
1041C0700X
Clinical Social Worker
Primary
11193-123
WI
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/07/2020
Last updated
02/04/2026
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