Individual provider Active NPI

Tesia Shirlynn Heard, LCSW

  • Clinical Social Worker
  • Newport News, VA
National Provider Identifier
1730802299
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904014275 Issued in VA
Practice address
739 Thimble Shoals Blvd BLDG 704
Newport News, VA 23606-3562
Phone
(757) 272-6330
Fax
(757) 765-7709
NPI assigned
Sep 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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 0904014275 VA Primary

Addresses

Primary practice location

739 Thimble Shoals Blvd BLDG 704
Newport News, VA 23606-3562

Mailing address

739 Thimble Shoals Blvd BLDG 704
Newport News, VA 23606-3562
Phone (757) 272-6330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240214000019 VA Practitioner - Clinical Social Worker 5890146450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904014275VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Foundations to Success, LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1730802299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 THIMBLE SHOALS BLVD BLDG 704",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063562",
            "telephone_number": "757-272-6330",
            "fax_number": "757-765-7709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 THIMBLE SHOALS BLVD BLDG 704",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063562",
            "telephone_number": "757-272-6330",
            "fax_number": "757-765-7709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARD",
        "first_name": "TESIA",
        "middle_name": "SHIRLYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904014275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.