Theresa Flora Wiss, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2022028185 Issued in MO

Practice address

1215 Fern Ridge Pkwy Ste 110
Saint Louis, MO 63141-4405

Phone

(314) 275-8599

NPI assigned

Jun 20, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Madmar LLCGroup PAC ID 8628516119, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Madmar, LLC

  • Counselor
  • Saint Louis, MO
  • NPI 1053152892
  Medicare reassignment Care Compare group NPD
• Theresa Wiss LCSW LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Maplewood, MO
  • NPI 1578498960
  NPD Authorized official

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1780369405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6925 COLUMBIA AVE",
            "city": "UNIVERSITY CITY",
            "state": "MO",
            "postal_code": "631303127",
            "telephone_number": "860-324-3581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 FERN RIDGE PKWY STE 110",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631414405",
            "telephone_number": "314-275-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISS",
        "first_name": "THERESA",
        "middle_name": "FLORA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2022028185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Wisemore, OT
• Deborah Ann Wiser
• Wishing Well Counseling, LLC
• Jamieson A Wishman, CRNA
• Madeleine Wisler, MS
• Katherine Grace Wissing
• Douglas Kyle Wissler, DMD
• Bradley Carl Witbrodt, M.D.
• With Every Breath Doula Services LLC
• With Kare CDS Services LLC

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

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