Individual provider Active NPI

Theresa Lynn Fosmire, LCSW

  • Clinical Social Worker
  • Hendersonville, NC
National Provider Identifier
1063463693
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C002319 Issued in NC
Practice address
711 S Grove St Ste B
Hendersonville, NC 28792-5791
Phone
(828) 692-7300
Fax
(828) 692-7710
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C002319 NC Primary

Addresses

Primary practice location

711 S Grove St Ste B
Hendersonville, NC 28792-5791

Mailing address

PO Box 2272
Hendersonville, NC 28793-2272
Phone (828) 692-7300

Other practice location 1

110 Williams St
Hendersonville, NC 28792-4543
Phone (828) 692-7300

Other identifiers 1

IdentifierTypeStateIssuer
6002699MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090624000526 NC Practitioner - Clinical Social Worker 2860543238 Practice locations: Hendersonville, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of South Carolina School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

711 S Grove St
Suite B
Hendersonville, NC 28792-5791
Phone (828) 692-7300

P O Box
Suite 2272
Hendersonville, NC 28793-2272

PO Box
Suite 2272
Hendersonville, NC 28793-2272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C002319NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Counseling Associates Clinical PastSince Feb 9, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1063463693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2272",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287932272",
            "telephone_number": "828-692-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S GROVE ST STE B",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287925791",
            "telephone_number": "828-692-7300",
            "fax_number": "828-692-7710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Williams St",
            "address_purpose": "LOCATION",
            "city": "Hendersonville",
            "state": "NC",
            "postal_code": "287924543",
            "country_code": "US",
            "telephone_number": "828-692-7300",
            "fax_number": "828-692-7710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOSMIRE",
        "first_name": "THERESA",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002699",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, NC

Sources for this page

Verify at the official NPI Registry.