Individual provider Active NPI

Teri L Holter, LCSW, DCSW

  • Clinical Social Worker
  • Makawao, HI
National Provider Identifier
1801018510
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-1076 Issued in HI
Practice address
1170 Makawao Ave
Makawao, HI 96768-9448
Phone
(808) 572-5551
Fax
(808) 572-5554
NPI assigned
May 3, 2007
Last updated
Aug 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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 LCSW-1076 HI Primary

Addresses

Primary practice location

1170 Makawao Ave
Makawao, HI 96768-9448

Mailing address

PO Box 458
Makawao, HI 96768-0458
Phone (808) 205-8055

Other identifiers 1

IdentifierTypeStateIssuer
566763.01MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20050812000069 HI Practitioner - Clinical Social Worker 1052340718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3660 Baldwin Ave
Makawao, HI 96768-7503
Phone (808) 205-8055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-1076HIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mauka Physical Therapy, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1801018510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 458",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967680458",
            "telephone_number": "808-205-8055",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 MAKAWAO AVE",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967689448",
            "telephone_number": "808-572-5551",
            "fax_number": "808-572-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTER",
        "first_name": "TERI",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LCSW, DCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW-1076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "566763.01",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Makawao, HI

Sources for this page

Verify at the official NPI Registry.