Tegmentum Counseling Services LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

TEGMENTUM COUNSELING SERVICES LLC

Practice address

1033 W Pennwood St
Meridian, ID 83642-2878

Phone

(208) 409-1354

NPI assigned

Mar 20, 2023

Organization subpart

No

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

Authorized official

Name

Kersondra Corrine Hood, LCSW, ACADC

Title

Owner

Phone

(208) 409-1354

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1689376238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 W PENNWOOD ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422878",
            "telephone_number": "208-409-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 W PENNWOOD ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422878",
            "telephone_number": "208-409-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEGMENTUM COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-19",
        "status": "A",
        "authorized_official_last_name": "HOOD",
        "authorized_official_first_name": "KERSONDRA",
        "authorized_official_middle_name": "CORRINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-409-1354",
        "authorized_official_credential": "LCSW, ACADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Meridian, ID
• Providers in Meridian, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.