Teresia Mortenson, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9728 Issued in MN

Practice address

401 W Laurel St Ste C
Brainerd, MN 56401-3970

Phone

(218) 454-3288

NPI assigned

Sep 19, 2023

Last updated

Sep 19, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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 MN

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The TherapistGroup PAC ID 7618383951, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Therapist

  dba The Therapist PLC

  • Professional Counselor
  • Brainerd, MN
  • NPI 1093263113
  Medicare reassignment Care Compare group NPD
• Senior Care Consulting, LLC

  dba Age Well Therapy

  • Clinical Social Worker
  • Crosslake, MN
  • NPI 1164363917
  NPD Authorized official

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1811775968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14399 ANDERSEN DR",
            "city": "CROSSLAKE",
            "state": "MN",
            "postal_code": "564423500",
            "telephone_number": "218-839-2869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W LAUREL ST STE C",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013970",
            "telephone_number": "218-454-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSON",
        "first_name": "TERESIA",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "9728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Terese Monson, LICSW
• David Joseph Montecino, LADC, ADCR-MN, NCPT3
• Desiree Ann Montonye Johnson, LADC
• Sadie Moore, CCC-SLP
• Thomas J Moraghan, MD
• Megan Kay Mueller, MS
• Tamara Muesing, PA-C
• Catherine M Munson, LGSW
• Robin Myers, RPH
• Mysa Counseling PLLC

• Clinical Social Worker in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.