Individual provider Active NPI

Theresa L. Gachuna, LICSW

  • Clinical Social Worker
  • Gardner, MA
National Provider Identifier
1659438794
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
114614 Issued in MA
Practice address
175 Connors Street
Gardner, MA 01440
Phone
(978) 410-6131
Fax
(978) 410-6106
NPI assigned
Jan 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 114614 MA Primary

Addresses

Primary practice location

175 Connors Street
Gardner, MA 01440

Mailing address

326 Nichols Road
Fitchburg, MA 01420
Phone (978) 878-8516

Other names 1

  • Miss Theresa Lorraine Gachuna Former name

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
114614MAMDNeuroscience Clinical Nurse Specialist

Interoperability endpoints

  • Direct secure messaging: theresa.gachuna.p1@direct.chcfhc.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1659438794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 NICHOLS ROAD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "01420",
            "telephone_number": "978-878-8516",
            "fax_number": "978-878-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CONNORS STREET",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "01440",
            "telephone_number": "978-410-6131",
            "fax_number": "978-410-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GACHUNA",
        "first_name": "THERESA",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-01",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "GACHUNA",
            "middle_name": "LORRAINE",
            "prefix": "MISS",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gardner, MA

Sources for this page

Verify at the official NPI Registry.