Active NPI
Teresa Mazda
- Clinical Social Worker
- Glen Mills, PA
National Provider Identifier
1174891592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW017073
- Practice address
- 871 Baltimore Pike
Unit 32
Glen Mills, PA 19342 - Phone
- (610) 644-6464
- NPI assigned
- Dec 13, 2011
- 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 | CW017073 | PA | Primary |
Addresses
Primary practice location
871 Baltimore Pike
Unit 32
Glen Mills, PA 19342
Mailing address
1440 Russell Rd
Paoli, PA 19301-1236
Phone (610) 644-6464
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CW017073 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323734400000",
"number": "1174891592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1440 RUSSELL RD",
"city": "PAOLI",
"state": "PA",
"postal_code": "193011236",
"telephone_number": "610-644-6464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "871 BALTIMORE PIKE",
"address_2": "UNIT 32",
"city": "GLEN MILLS",
"state": "PA",
"postal_code": "19342",
"telephone_number": "610-644-6464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZDA",
"first_name": "TERESA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-13",
"last_updated": "2011-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW017073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Mills, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.