Teresa Klavekoske

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3768 Issued in WI

Practice address

1721 Saemann Ave
Sheboygan, WI 53081-2342

Phone

(920) 783-6633

Fax

(920) 783-6392

NPI assigned

Jan 5, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Clinical Social Worker

Education

Other, 1993

Medicare assignment

May accept Medicare assignment

Group practices

Lakeshore Community Health Care, IncGroup PAC ID 3173773124, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tklavekoske364080@direct.ochin.org

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.

• Lakeshore Community Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Sheboygan, WI
  • NPI 1245520519
  Medicare reassignment Care Compare group NPD
• Lakeshore Community Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • West Bend, WI
  • NPI 1184358004
  NPD
• Lakeshore Community Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Manitowoc, WI
  • NPI 1245502673
  NPD

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

{
    "created_epoch": "1483574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1447795083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530820959",
            "telephone_number": "920-783-6633",
            "fax_number": "920-783-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 SAEMANN AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530812342",
            "telephone_number": "920-783-6633",
            "fax_number": "920-783-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAVEKOSKE",
        "first_name": "TERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-05",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "11431",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "3768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karim Kibaa, MD
• Kellie Kidd-Thelen, PTA
• Kathleen M Kiel, LPN
• Joel Kirchstein, LPC
• Wendy Marie Kirst, L.P.N.
• Jokasha E Klest, LCSW
• Allisyn Kleutsch-Palma, AUD
• Sheila Kloepping
• Maryellen Kloiber, PT
• Thomas Carl Kloiber, D.C.

• Clinical Social Worker in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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.