Individual provider Active NPI

Heather Ann Teadt, LLMSW

  • Social Worker
  • Centreville, MI
National Provider Identifier
1407436215
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801105551 Issued in MI
Practice address
677 E Main St
Centreville, MI 49032-8524
Phone
(269) 467-1000
NPI assigned
Apr 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801105551 MI Primary

Addresses

Primary practice location

677 E Main St
Centreville, MI 49032-8524

Mailing address

677 E Main St
Centreville, MI 49032-8524
Phone (269) 467-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20230523001379 MI Practitioner - Clinical Social Worker 8022474717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Mental Health Services of St Joseph CountyGroup PAC ID 9032178496, 17 clinicians

Practice addresses (Care Compare)

677 E Main St
Centreville, MI 49032-8524
Phone (269) 467-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801105551MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health Services of St Joseph County CurrentSince Apr 20, 2023 Accepting new patients

Locations

677 E Main St
Centreville, MI 49032
Phone (269) 467-1001

677 E Main St
Ste A
Centreville, MI 49032
Phone (269) 467-1001

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1407436215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 E MAIN ST",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "490328524",
            "telephone_number": "269-467-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 E MAIN ST",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "490328524",
            "telephone_number": "269-467-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEADT",
        "first_name": "HEATHER",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801105551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, MI

Sources for this page

Verify at the official NPI Registry.