Active NPI
Teresa Ellstrom
- Social Worker
- Johnston, RI
National Provider Identifier
1346932563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ISW04050
- Practice address
- 1443 Hartford Ave
Johnston, RI 02919-3224 - Phone
- (401) 273-8100
- NPI assigned
- May 25, 2023
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | ISW04050 | RI | Primary |
Addresses
Primary practice location
1443 Hartford Ave
Johnston, RI 02919-3224
Mailing address
115 Intervale Rd
Cranston, RI 02910-5245
Phone (508) 685-2899
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW04050 | RI | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Service of Rhode Island, Inc. | Current | Accepting new patients |
Locations
55 Hope St
Providence, RI 02906
Phone (401) 519-2230
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 and National Provider Directory roles.
-
- Adult Mental Health Clinic/Center
- Providence, RI
- NPI 1598833535
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709596800000",
"number": "1346932563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 INTERVALE RD",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029105245",
"telephone_number": "508-685-2899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1443 HARTFORD AVE",
"city": "JOHNSTON",
"state": "RI",
"postal_code": "029193224",
"telephone_number": "401-273-8100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLSTROM",
"first_name": "TERESA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-25",
"last_updated": "2024-03-05",
"certification_date": "2024-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "RI",
"license": "ISW04050",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnston, RI
- Christopher Durkin, LCSW
- Dawn Maria Dyer, RN
- Alicia Ead, LICSW
- Kyle Edward, M.ED
- Katarina Ellerbe
- Tasneem Elsafi, DMD
- Empower Wellness LLC
- Empowered Legacy Center (None)
- Encompass Health Rehabilitation Hospital of Johnston, LLC (Encompass Health Rehabilitation Hospital of Johnston)
- Wayne P Estes, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.