Active NPI
Theresa J Marsh, LSCSW
- Clinical Social Worker
- Wichita, KS
National Provider Identifier
1124045653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LSCSW0790
- Practice address
- 1148 South Hillside
Suite 104
Wichita, KS 67211-4005 - Phone
- (316) 687-0006
- Fax
- (316) 687-0328
- NPI assigned
- Jul 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LSCSW0790 | KS | Primary |
Addresses
Primary practice location
1148 South Hillside
Suite 104
Wichita, KS 67211-4005
Mailing address
1148 South Hillside
Suite 104
Wichita, KS 67211-4005
Phone (316) 687-0006
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 066014 | Other | KS | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050706000348 | KS | Practitioner - Clinical Social Worker | 4486690906 | Practice locations: Wichita, KS |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1148 S Hillside St
Wichita, KS 67211-4005
Phone (316) 687-0006
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LSCSW0790 | KS | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124045653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1148 SOUTH HILLSIDE",
"address_2": "SUITE 104",
"city": "WICHITA",
"state": "KS",
"postal_code": "672114005",
"telephone_number": "316-687-0006",
"fax_number": "316-687-0328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1148 SOUTH HILLSIDE",
"address_2": "SUITE 104",
"city": "WICHITA",
"state": "KS",
"postal_code": "672114005",
"telephone_number": "316-687-0006",
"fax_number": "316-687-0328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSH",
"first_name": "THERESA",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "LSCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KS",
"license": "LSCSW0790",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "066014",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.