Active NPI
Teresa Lynn Lewis, LCSW
- Clinical Social Worker
- Bethel, AK
National Provider Identifier
1265557375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 614 LCSW
- Practice address
- 829 Chief Eddie Hoffman Hwy
Bethel, AK 99559 - Phone
- (907) 543-6199
- NPI assigned
- Mar 20, 2007
- Last updated
- Aug 13, 2012
- 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 | 614 LCSW | MT | Primary |
Addresses
Primary practice location
829 Chief Eddie Hoffman Hwy
Bethel, AK 99559
Mailing address
PO Box 528
Bethel, AK 99559-0528
Phone (907) 543-6199
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MH0150 | Medicaid | AK | |
| 614 LCSW | Other | MT | LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 614 LCSW | MT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
Interoperability endpoints
- teresalewis@tdh.allscriptsdirect.net
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": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344816000000",
"number": "1265557375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 528",
"city": "BETHEL",
"state": "AK",
"postal_code": "995590528",
"telephone_number": "907-543-6199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "829 CHIEF EDDIE HOFFMAN HWY",
"city": "BETHEL",
"state": "AK",
"postal_code": "99559",
"telephone_number": "907-543-6199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "TERESA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2012-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MT",
"license": "614 LCSW",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MH0150",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "614 LCSW",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethel, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.