Individual provider Active NPI

Teresita Guerra, LICSW

  • Clinical Social Worker
  • Holyoke, MA
National Provider Identifier
1164903100
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW03502 Issued in RI
Practice address
57 Suffolk St
Holyoke, MA 01040-5090
Phone
(413) 534-2000
NPI assigned
Aug 28, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Counselor 101YS0200X 1025117 MA
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X ISW03502 RI Primary

Addresses

Primary practice location

57 Suffolk St
Holyoke, MA 01040-5090

Mailing address

3 Fenton St
Holyoke, MA 01040-1092
Phone (413) 210-9295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190401000916 MA Practitioner - Clinical Social Worker 0941541965 Reassigns benefits to 1 organization
I20220606001589 RI Practitioner - Clinical Social Worker 0941541965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rhode Island Counseling Associates LLCGroup PAC ID 7618219544, 42 clinicians

Practice addresses (Care Compare)

1150 Reservoir Ave
Suite 203
Cranston, RI 02920-6043
Phone (401) 259-0340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1025117MAMDSchool Counselor
ISW03502RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Counseling Associates LLC Multi-Specialty CurrentSince May 19, 2022 Accepting new patients
Umass Memorial Health-Harrington Hospital Inc Multi-Specialty CurrentSince Feb 17, 2019 Accepting new patients
City of Holyoke Past Accepting new patients

Locations

100 South St
Southbridge, MA 01550
Phone (508) 764-8012

29 Pine St
Southbridge, MA 01550
Phone (508) 765-2202

1150 Reservoir Ave
Ste 203
Cranston, RI 02920
Phone (401) 259-0340

Organizations & group practices 3

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": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1164903100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 FENTON ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010401092",
            "telephone_number": "413-210-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 SUFFOLK ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010405090",
            "telephone_number": "413-534-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRA",
        "first_name": "TERESITA",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "MA",
            "license": "1025117",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW03502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holyoke, MA

Sources for this page

Verify at the official NPI Registry.