Individual provider Active NPI

Teresa Lynn Hastings, PHD

  • Psychologist
  • Lynnwood, WA
National Provider Identifier
1871817841
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
487 Issued in SD
Practice address
3512 204TH St SW Apt H105
Lynnwood, WA 98036-6888
Phone
(206) 790-0684
NPI assigned
Mar 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 487 SD Primary

Addresses

Primary practice location

3512 204TH St SW Apt H105
Lynnwood, WA 98036-6888

Mailing address

3512 204TH St SW Apt H105
Lynnwood, WA 98036-6888
Phone (206) 790-0684

Other identifiers 1

IdentifierTypeStateIssuer
PY00002375OtherWACLINICAL PSYCHOLOGY LICENSE

Other names 1

  • Teresa L Crain Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240514000080 WA Practitioner - Clinical Psychologist 2062549942 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Total Life IncGroup PAC ID 8123433034, 113 clinicians

Practice addresses (Care Compare)

1400 112TH Ave SE
Suite 100 103
Bellevue, WA 98004-6901
Phone (800) 567-5433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
487SDMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Life Inc. CurrentSince May 1, 2024 Accepting new patients
Total Life FL PA CurrentSince Sep 1, 2025 Accepting new patients

Locations

110 Front St
Ste 300
Jupiter, FL 33477
Phone (205) 246-5690

1400 112th Ave SE
Ste 100103
Bellevue, WA 98004
Phone (205) 246-5690

1400 112th Ave SE
Bellevue, WA 98004
Phone (206) 226-7826

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1871817841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3512 204TH ST SW APT H105",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366888",
            "telephone_number": "206-790-0684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 204TH ST SW APT H105",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366888",
            "telephone_number": "206-790-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASTINGS",
        "first_name": "TERESA",
        "middle_name": "LYNN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-19",
        "last_updated": "2024-05-06",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "SD",
            "license": "487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL PSYCHOLOGY LICENSE",
            "identifier": "PY00002375",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "CRAIN",
            "middle_name": "L",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lynnwood, WA

Sources for this page

Verify at the official NPI Registry.