Teresa W Syversen, CADC I

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

906 Main Ave
Tillamook, OR 97141-3816

Phone

(503) 842-8201

Fax

(503) 815-1870

NPI assigned

Mar 2, 2007

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

Other identifiers 1

Other names 1

• Terri W Syversen Other name

Medicare fee-for-service enrollment

Enrolled in OR

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

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tillamook Family Counseling CenterGroup PAC ID 3375443864, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/tfcc/r4/

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.

• Tillamook Family Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tillamook, OR
  • NPI 1659380145
  Medicare reassignment Care Compare group NPD
• Tillamook Family Counseling Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tillamook, OR
  • NPI 1063623478
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1871622332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9875 CHANCE RD",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "97141",
            "telephone_number": "503-842-8201",
            "fax_number": "503-815-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 MAIN AVE",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971413816",
            "telephone_number": "503-842-8201",
            "fax_number": "503-815-1870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYVERSEN",
        "first_name": "TERESA",
        "middle_name": "W",
        "credential": "CADC I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197749",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRI",
            "last_name": "SYVERSEN",
            "middle_name": "W",
            "credential": "CADC I",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ardath Stout, LCSW
• Patrick John Sullivan, PHARMD
• Connie Louise Sutton, LPC
• Alysa Swede, MA
• Megan Leigh Swenson, MSN, RN
• Allyson Marie Taylor, MA, LPA
• Ashley Lisa Thiessen, NP, DNP
• Thompson Mainstay LLC
• Tiffani a. Long DDS
• Tillamook Chiropractic Incorporated

• Addiction (Substance Use Disorder) Counselor in Tillamook, OR
• Providers in Tillamook, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.