Tresa Harris Richardson, MSW, LCSW, ACSW
Individual provider Active NPI Clinical Social Worker · New London, MO
NPI 1023305166 · NPPES record last updated Jul 8, 2011
Key facts
- NPI
- 1023305166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 001081 (MO)
- Practice address
- 12496 Old 79
New London, MO 63459-2741 - Phone
- (573) 248-2051
- Fax
- (573) 248-2051
- NPI assigned
- Jul 8, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- University of Missouri, Columbia School of Medicine, 1981
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
737 Dunn Rd
Hazelwood, MO 63042-1740
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260121001530 | MO | Practitioner - Clinical Social Worker | 7810474863 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.012904 | IL | MD | Clinical Social Worker |
| 001081 | MO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walters Walk | Current |
Accepting new patients |
Locations
737 Dunn Rd
Hazelwood, MO 63042
Phone (314) 472-3433
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 001081 | MO | Yes |
| Clinical Social Worker | 1041C0700X | 149.012904 | IL |
Addresses
Primary practice location
12496 Old 79
New London, MO 63459-2741
Mailing address
12496 Old 79
New London, MO 63459-2741
Phone (573) 248-2051
Other providers in New London, MO
- Comprehensive Health Systems, Inc.
- Independent Mobility LLC
- Preferred Family Healthcare, Inc
- Ralls County Health Department
- Michael David Richardson
- Amber Roberts
- Kim Robinson
All providers in New London, MO · Clinical Social Worker in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.