Individual provider Active NPI

Teresa Land, MSW, LCSW

  • Clinical Social Worker
  • Avon, IN
National Provider Identifier
1245901230
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34006472A Issued in IN
Practice address
10080 E US Highway 36 Ste a
Avon, IN 46123-8174
Phone
(317) 790-9396
NPI assigned
Sep 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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 34006472A IN Primary

Addresses

Primary practice location

10080 E US Highway 36 Ste a
Avon, IN 46123-8174

Mailing address

10080 E US Highway 36 Ste a
Avon, IN 46123-8174
Phone (317) 790-9396

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
34006472AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Care to Change, LLC PastSince Sep 28, 2021 Accepting new patients

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": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1245901230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10080 E US HIGHWAY 36 STE A",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461238174",
            "telephone_number": "317-790-9396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10080 E US HIGHWAY 36 STE A",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461238174",
            "telephone_number": "317-790-9396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAND",
        "first_name": "TERESA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006472A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.