Theresa Kay Deyoung-Foster, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801085753 Issued in MI

Practice address

57239 N Main St Ste 1
Three Rivers, MI 49093-9419

Phone

(269) 273-0030

NPI assigned

Jul 22, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1043883473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 FAIRFIELD AVE.",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490482666",
            "telephone_number": "269-370-9413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57239 N MAIN ST STE 1",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490939419",
            "telephone_number": "269-273-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYOUNG-FOSTER",
        "first_name": "THERESA",
        "middle_name": "KAY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801085753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylynn Decarli, D.O
• Jennaya Decker
• Autumn Brooke Delnat, M.A., LPC, CSAYC
• Jean Demro, RPH
• Terri Dennis, NP
• Nikita Lashae Dixon
• Doctor Hohman Enterprises
• Sharon Gail Dolfin, MA, CCC-SLP
• Chloe Dugan
• Brooke Taylor Eager

• All providers in Three Rivers, MI
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.