Emily Tetalman, LCSW
Individual provider Active NPI Clinical Social Worker · Richmond, VA
NPI 1275928962 · NPPES record last updated Sep 24, 2019
Key facts
- NPI
- 1275928962
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 0904008816 (VA)
- Practice address
- 517 W Grace St
Richmond, VA 23220-4911 - Phone
- (804) 783-2505
- Fax
- (804) 521-5319
- NPI assigned
- Mar 31, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Daily Planet Inc
Practice addresses (Care Compare)
511 W Grace St
Richmond, VA 23220-4911
Phone (804) 783-2505
517 W Grace St
Richmond, VA 23220-4911
Phone (804) 783-2505
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151217001344 | VA | Practitioner - Clinical Social Worker | 6608177555 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904008816 | VA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Daily Planet Inc, | Current |
Accepting new patients | |
| The Daily Planet Inc | Current |
Accepting new patients | |
| River City Integrative Counseling | Past | Accepting new patients |
Locations
517 W Grace St
Richmond, VA 23220
Phone (804) 783-0678
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904008816 | VA | Yes |
Addresses
Primary practice location
517 W Grace St
Richmond, VA 23220-4911
Mailing address
517 W Grace St
Richmond, VA 23220-4911
Phone (804) 783-2505
Other providers in Richmond, VA
- John Tessarzik
- Stephanie Tessarzik
- Tesseract VA LLC
- Claudia M Testa
- Joseph W. Testa
- Brieanna Thacker
- Sarah Thacker
- Derek Thackston
- Joshua Caleb Thai
- Bhavnita Patel Thakor
All providers in Richmond, VA · Clinical Social Worker in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.