Theresa A Wiese, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149021439 Issued in IL

Practice address

310 Hillcrest Dr
Washington, IL 61571-2221

Phone

(309) 645-1318

NPI assigned

Apr 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1891750816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 HILLCREST DR",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615712221",
            "telephone_number": "309-645-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HILLCREST DR",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615712221",
            "telephone_number": "309-645-1318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "THERESA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149021439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Washington Village Estates, LP
• Washington Volunteer Fire Department and Rescue Squad Inc
• Kelly L Watkins, SPEECH LANG PATH
• Lily Watts
• Kristy Lyn Wheeler, BCBA, NCSP
• Jennifer M Wilson, OD
• Jill Wirth-Rissman, MD
• Wolf Larson Enterprises LLC
• Carrie Marie Woodward, RN
• Christopher S Wright

• Clinical Social Worker in Washington, IL
• Providers in Washington, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.