Individual provider Active NPI

Teresa J. Guerrero, L.I.C.S.W.

  • Clinical Social Worker
  • Duluth, MN
National Provider Identifier
1205539756
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12930 Issued in MN
Practice address
715 E Central Entrance
Duluth, MN 55811-5596
Phone
(218) 723-8153
Fax
(218) 722-7625
NPI assigned
Mar 23, 2023
Last updated
Mar 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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 12930 MN Primary

Addresses

Primary practice location

715 E Central Entrance
Duluth, MN 55811-5596

Mailing address

715 E Central Entrance
Duluth, MN 55811-5596
Phone (218) 723-8153

Other names 1

  • Mrs. Teresa J Aldach Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20050216000505 MN Practitioner - Clinical Social Worker 8123070349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arrowhead Psychological Clinic, P.a.Group PAC ID 4880629633, 9 clinicians

Practice addresses (Care Compare)

715 E Central Entrance
Duluth, MN 55811-5596
Phone (218) 723-8153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12930MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arrowhead Psychological Clinic, P.a. CurrentSince Jun 25, 2023 Accepting new patients

Locations

715 E Central Entrance
Duluth, MN 55811
Phone (218) 723-8153

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1205539756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 E CENTRAL ENTRANCE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558115596",
            "telephone_number": "218-723-8153",
            "fax_number": "218-722-7625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 E CENTRAL ENTRANCE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558115596",
            "telephone_number": "218-723-8153",
            "fax_number": "218-722-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "TERESA",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "12930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "ALDACH",
            "middle_name": "J",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.