Individual provider Active NPI

Vonnie Marie Teagarden, LCSW

  • Clinical Social Worker
  • Waynesburg, PA
National Provider Identifier
1790722510
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW012252 Issued in PA
Practice address
64 N Richhill St
Suite 2
Waynesburg, PA 15370-1306
Phone
(724) 852-1614
Fax
(724) 852-1614
NPI assigned
Jun 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 CW012252 PA Primary

Addresses

Primary practice location

64 N Richhill St
Suite 2
Waynesburg, PA 15370-1306

Mailing address

64 N Richhill St
Suite 2
Waynesburg, PA 15370-1306
Phone (724) 852-1614

Other identifiers 3

IdentifierTypeStateIssuer
004479EMedicaidPA
118496OtherPAMHN
165765OtherPAVALUE OPTIONS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20060503000029 PA Practitioner - Clinical Social Worker 5698785889 Practice locations: Waynesburg, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

64 N Richhill St
Suite 2
Waynesburg, PA 15370-1306
Phone (724) 852-1614

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW012252PAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1790722510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 N RICHHILL ST",
            "address_2": "SUITE 2",
            "city": "WAYNESBURG",
            "state": "PA",
            "postal_code": "153701306",
            "telephone_number": "724-852-1614",
            "fax_number": "724-852-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 N RICHHILL ST",
            "address_2": "SUITE 2",
            "city": "WAYNESBURG",
            "state": "PA",
            "postal_code": "153701306",
            "telephone_number": "724-852-1614",
            "fax_number": "724-852-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAGARDEN",
        "first_name": "VONNIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW012252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004479E",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "118496",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "165765",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesburg, PA

Sources for this page

Verify at the official NPI Registry.