Individual provider Active NPI

Teresa C. Von Woglom, LCSW, LPC

  • Clinical Social Worker
  • Tomball, TX
National Provider Identifier
1184726036
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
02267 Issued in TX
Practice address
455 School St
Suite 14
Tomball, TX 77375-4593
Phone
(281) 351-6561
Fax
(281) 516-7159
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 02267 TX Primary

Addresses

Primary practice location

455 School St
Suite 14
Tomball, TX 77375-4593

Mailing address

455 School St
Suite 14
Tomball, TX 77375-4593
Phone (281) 351-6561

Other identifiers 2

IdentifierTypeStateIssuer
226924OtherTXVALUE OPTIONS
0099JNOtherTXBCBS

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

LicenseStateTypeSpecialty
02267TXMDClinical Social Worker
2267TXMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1184726036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 SCHOOL ST",
            "address_2": "SUITE 14",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773754593",
            "telephone_number": "281-351-6561",
            "fax_number": "281-516-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 SCHOOL ST",
            "address_2": "SUITE 14",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773754593",
            "telephone_number": "281-351-6561",
            "fax_number": "281-516-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON WOGLOM",
        "first_name": "TERESA",
        "middle_name": "C.",
        "name_prefix": "Ms.",
        "credential": "LCSW, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "02267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "226924",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0099JN",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomball, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.