Teresa L Largaespada, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4430 Issued in MN

Practice address

1585 Blair Ave
Saint Paul, MN 55104

Phone

(612) 423-8231

NPI assigned

Oct 16, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

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, 2005

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Both Sides of the River Counseling

  • Clinical Social Worker
  • Saint Paul, MN
  • NPI 1578075354

  Clinical

  NPD (past) Authorized official

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242864000000",
    "number": "1962654350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 BLAIR AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "612-423-8231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 BLAIR AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "612-423-8231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARGAESPADA",
        "first_name": "TERESA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-16",
        "last_updated": "2009-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "3044",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7515-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "4430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "7515-123",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "127713-121",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ali Lanz, CNM
• My Lao, LPN
• Emily Laplant
• Caitlyn Sarah Lapres, CRNA
• Mary Beth Lardizabal, DO
• Larkey and Wright Inc
• Daniel E Larkin, MD
• Larkins Neurosurgery PA
• Jennifer Larklan, DPT
• Roger R Laroche, MD

• All providers in Saint Paul, MN
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2009; 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.