Teresa Shiraishi, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61003632 Issued in WA

Practice address

2800 Woodcock Rd
Sequim, WA 98382-7887

Phone

(360) 531-3897

NPI assigned

Dec 23, 2021

Last updated

Dec 23, 2021By the provider in NPPES

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

Opted out of Medicare

Yes, effective Dec 4, 2024 through Dec 4, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Teresa Shiraishi, Licsw, PLLC

  dba Shiraishi Counseling

  • Clinical Social Worker
  • Sequim, WA
  • NPI 1447911367
  NPD Authorized official

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

{
    "created_epoch": "1640217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1174283667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 WOODCOCK RD",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983827887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 WOODCOCK RD",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983827887",
            "telephone_number": "360-531-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRAISHI",
        "first_name": "TERESA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-23",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61003632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Binay Kumar Shah, MD
• Sheeler Denture Clinic
• Sindie Lou Sheeler, DN60313524
• Sherwood Medical Center
• Andy Andreyevich Shimchuk
• Mark Edward Sienko, M.D.
• Sight Partners Physicians, P.C.
• Elizabeth Inez Silva, LMSW, LSWAIC
• Michelle L Simmons-Wolfgang, LMP
• Sindie Sheeler Denture Clinic, LLC

• Clinical Social Worker in Sequim, WA
• Providers in Sequim, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.