Individual provider Active NPI

Teresa Chianello, PH.D., LCSW

  • Clinical Social Worker
  • Bend, OR
National Provider Identifier
1306178041
Registry record updated May 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2017 Issued in OR
Practice address
2052 NE 4TH Street
Bend, OR 97701
Phone
(541) 410-2274
NPI assigned
Feb 5, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2010

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 2017 OR Primary

Addresses

Primary practice location

2052 NE 4TH Street
Bend, OR 97701

Mailing address

P. O Box 8777
Bend, OR 97708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100923000219 OR Practitioner - Clinical Social Worker 1153447586 Practice locations: Bend, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2052 NE 4TH St
Bend, OR 97701-3825
Phone (541) 410-2274

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2017ORMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Resolutions Creative Conflict Management, Inc Clinical PastSince Dec 1, 2008 Accepting new patients
Judy Rotondi LLC Clinical Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273190400000",
    "number": "1306178041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O BOX 8777",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2052 NE 4TH STREET",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97701",
            "telephone_number": "541-410-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIANELLO",
        "first_name": "TERESA",
        "name_prefix": "Ms.",
        "credential": "PH.D., LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-05",
        "last_updated": "2010-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "2017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.