Theresa A Roche, MSW,LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2004008737 Issued in MO

Practice address

763 River Glen Dr
O Fallon, MO 63368-9647

Phone

(636) 244-1917

Fax

(636) 244-1917

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Terri A Roche Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Madmar, LLC

  • Counselor
  • Saint Louis, MO
  • NPI 1053152892
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431820800000",
    "number": "1215955463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 RIVER GLEN DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633689647",
            "telephone_number": "314-650-7768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 RIVER GLEN DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633689647",
            "telephone_number": "636-244-1917",
            "fax_number": "636-244-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHE",
        "first_name": "THERESA",
        "middle_name": "A",
        "credential": "MSW,LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2015-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2004008737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497324103",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRI",
            "last_name": "ROCHE",
            "middle_name": "A",
            "credential": "MSW,LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Ashley Kay Robel, D.C.
• Shannon Roberson, LPC
• Roberta'S Home Health Services LLC
• Kaiden Conner Robinson, D.C.
• Nicholas Rocco, DPT
• Darren McKay Rodabough, DDS, MS
• Meagan Rodenberg, OTR/L
• Shannon Raye Roderique, LPTA
• Emma Taylor Rodgers
• Melissa Roewe, DO

• Clinical Social Worker in O Fallon, MO
• Providers in O Fallon, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2015; 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.