Terri Eidem, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

60346 Issued in TX

Practice address

2020 FM 967
Buda, TX 78610-2877

Phone

(512) 523-8777

NPI assigned

Jan 5, 2019

Last updated

Jan 5, 2019By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Terri Eidem Counseling LLC

  • Clinical Social Worker
  • Buda, TX
  • NPI 1528525037
  Authorized official Same address or phone

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

{
    "created_epoch": "1546646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546646400000",
    "number": "1295208957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 RIVER LAKES LN",
            "city": "MARTINDALE",
            "state": "TX",
            "postal_code": "786553907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 FM 967",
            "city": "BUDA",
            "state": "TX",
            "postal_code": "786102877",
            "telephone_number": "512-523-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDEM",
        "first_name": "TERRI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-05",
        "last_updated": "2019-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "60346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF TEXAS DRIVER LICENSE",
            "identifier": "24339407",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF SOCIAL WORK EXAMINERS",
            "identifier": "60346",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alejandra Jomayra Dominguez, BCBA
• Marisol Dominguez
• Donald C Taylor DDS PA (Buda Dental Professionals)
• Ashley Dowell, CPHT
• Nicholas Dunn
• Lenka Entner
• Carol Beth Evans, DDS
• Evans/Koen Main St Dental PLLC (Main Street Dental)
• Evergreen Counseling & Mediation, PLLC
• Barbara Farmer

• Clinical Social Worker in Buda, TX
• Providers in Buda, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2019; 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.