Individual
LEE THAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC, LADC
Contact information
Practice address
2345 RICE ST STE 145, ROSEVILLE, MN 55113-3720
(612) 314-3076
(651) 251-4889
Mailing address
1377 COUNTY ROAD E W, ARDEN HILLS, MN 55112-3654
(612) 314-3076
(079) 313-1400
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305599
MN
101YM0800X
Mental Health Counselor
11190-125
WI
101YM0800X
Mental Health Counselor
127583
IA
101YM0800X
Mental Health Counselor
Primary
3470
MN
101YP2500X
Professional Counselor
3470
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972012391
—
MN
Enumeration date
09/28/2017
Last updated
03/17/2025
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