Teresa Jean Ingram, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW16570 Issued in FL

Practice address

3903 Paddlewheel CT
Brandon, FL 33511-7959

Phone

(480) 220-8926

Fax

(802) 208-9264

NPI assigned

Dec 29, 2011

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 names 1

• Teresa Jean White Former name

Medicare fee-for-service enrollment

Enrolled in FL, PA, AZ3 enrollments

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 3

Specialty

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brave Health Inc.Group PAC ID 8123458981, 112 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Brave Health Inc.

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1821588674

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  AZ, Clinical, PA

  Medicare reassignment NPD

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1366711855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 PADDLEWHEEL CT",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335117959",
            "telephone_number": "480-220-8926",
            "fax_number": "802-208-9264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 PADDLEWHEEL CT",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335117959",
            "telephone_number": "480-220-8926",
            "fax_number": "802-208-9264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "TERESA",
        "middle_name": "JEAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-29",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "WHITE",
            "middle_name": "JEAN",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jean Paul Inesta Rivera, MD
• Infinite Tender Loving Care
• Jacquelyn Vanessa Ingar
• Faith Ingraham
• Brooke Ingram, S.I.
• Inner Compass Counseling Services, LLC
• Innovative Dental Solution of Brandon,LLC
• Tracy Winn Intartaglia
• Integraone LLC
• Integrated Community Oncology Network LLC (Cyberknife Cancer Center at Brandon Regional Hospital)

• Clinical Social Worker in Brandon, FL
• Providers in Brandon, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.