Individual provider Active NPI

Teresa M Kirchner, LICSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1922166255
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60408905 Issued in WA
Practice address
134 N 4TH St
Brooklyn, NY 11249-3296
Phone
(360) 993-3000
Fax
(360) 993-3047
NPI assigned
Dec 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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 LW60408905 WA Primary

Addresses

Primary practice location

134 N 4TH St
Brooklyn, NY 11249-3296

Mailing address

134 N 4TH St
Brooklyn, NY 11249-3296
Phone (646) 450-7748

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR, ID3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210325000761 WA Practitioner - Clinical Social Worker 8527475243 Reassigns benefits to 2 organizations
I20221107001433 OR Practitioner - Clinical Social Worker 8527475243 Reassigns benefits to 1 organization
I20221213000001 ID Practitioner - Clinical Social Worker 8527475243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Western Psychological and Counseling Services LLCGroup PAC ID 7719975085, 331 clinicians

Practice addresses (Care Compare)

2103 NE 129TH St
Suite 101
Vancouver, WA 98686-3270
Phone (360) 574-9303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW60408905WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Valera Medical, P.C. Counselor CurrentSince Jun 1, 2022 Accepting new patients
Multicare Health System CurrentSince Aug 26, 2022 Accepting new patients
Western Psychological and Counseling Services LLC Counselor CurrentSince Jan 18, 2026 Accepting new patients
Multicare Health System CurrentSince Aug 26, 2022 Accepting new patients
Valera Medical, P.a. Clinical CurrentSince Nov 15, 2022 Accepting new patients

Locations

3597 E Monarch Sky Ln
Ste 240
Meridian, ID 83646
Phone (208) 996-3519

134 N 4th St
Brooklyn, NY 11249

205 SE Spokane St
Ste 300
Portland, OR 97202
Phone (503) 388-4255

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

2103 NE 129th St
Ste 101
Vancouver, WA 98686
Phone (360) 574-9303

Organizations & group practices 6

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1922166255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 N 4TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112493296",
            "telephone_number": "646-450-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 N 4TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112493296",
            "telephone_number": "360-993-3000",
            "fax_number": "360-993-3047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRCHNER",
        "first_name": "TERESA",
        "middle_name": "M",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60408905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.