Individual provider Active NPI

Teresa Alt, MSW

  • Social Worker
  • Dublin, OH
National Provider Identifier
1174220073
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I-0009215-SUPV Issued in OH
Practice address
525 Metro PL N Ste 100
Dublin, OH 43017-5343
Phone
(855) 289-1722
NPI assigned
Feb 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-0009215-SUPV OH
School Social Worker 1041S0200X I-0009215-SUPV OH
Social Worker 104100000X I-0009215-SUPV OH Primary

Addresses

Primary practice location

525 Metro PL N Ste 100
Dublin, OH 43017-5343

Mailing address

525 Metro PL N Ste 100
Dublin, OH 43017-5343
Phone (855) 289-1722

Other identifiers 1

IdentifierTypeStateIssuer
2910854MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240130002816 OH Practitioner - Clinical Social Worker 5193178739 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Viaquest Psychiatric and Behavioral Solutions LLCGroup PAC ID 1153358486, 118 clinicians

Practice addresses (Care Compare)

525 Metro PL N
Suite 300
Dublin, OH 43017-5320
Phone (855) 289-1722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-0009215-SUPVOHMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center Street Community Clinic Inc CurrentSince Oct 12, 2023 Accepting new patients
Center Street Community Clinic, Inc Clinical CurrentSince Oct 12, 2023 Accepting new patients

Locations

136 W Center St
Marion, OH 43302
Phone (740) 751-4531

Interoperability endpoints

  • Direct secure messaging: teresa.alt.p1@direct.centerstreetclinic.nextgenshare.com

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": "1675987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1174220073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 METRO PL N STE 100",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175343",
            "telephone_number": "855-289-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 METRO PL N STE 100",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175343",
            "telephone_number": "855-289-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALT",
        "first_name": "TERESA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-10",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-0009215-SUPV",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "OH",
            "license": "I-0009215-SUPV",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I-0009215-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2910854",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.