Teresa Taft, M.S.W. LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00004278 Issued in WA

Practice address

12615 E Mission Ave
Suite 200
Spokane Valley, WA 99216-1047

Phone

(509) 228-1200

Fax

(509) 252-9300

NPI assigned

Oct 21, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Tess Kistler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199059200000",
    "number": "1548250533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3868",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992203868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12615 E MISSION AVE",
            "address_2": "SUITE 200",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161047",
            "telephone_number": "509-228-1200",
            "fax_number": "509-252-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAFT",
        "first_name": "TERESA",
        "credential": "M.S.W. LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2007-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00004278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7655221",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASURIS NW HEALTH",
            "identifier": "2687TA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO",
            "identifier": "000010148106",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TESS",
            "last_name": "KISTLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Roxanne Kristine Swofford, LMP
• Sycamore Glen SL
• Synergy Healthcare Inc.
• Zachary Michael Szabrowicz, MS
• T Daniel Dibble MD PC
• Tia Rae Tague, LMP
• Sara Talarico
• Talk, Learn and Communicate
• Michael Thomas Tamburello, LMP
• Lennart Cu Tan, MD

• Clinical Social Worker in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.