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NPI Code Detail

MEDICARE: TERASPOT, LLC

MEDICARE: TERASPOT, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11447884143OTHERINDIVIDUAL NPI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366059727
Entity Type Code : Organization
Provider Name (Legal Business Name) : TERASPOT, LLC
Provider Business Mailing Address
First Line : 306 N ROCK RD STE 30
Second Line :
City : WICHITA
State : KS
Zip : 67206-2256
Country : US
Telephone Number : 316-775-1415
Fax Number :
Provider Business Practice Location Address
First Line : 306 N ROCK RD STE 30
Second Line :
City : WICHITA
State : KS
Zip : 67206-2256
Country : US
Telephone Number : 316-775-1415
Fax Number :
Authorized Official
Title or Position : OWNER, THERAPIST
Name : MRS. GERMAINE C HALL
Credential : LMSW, CCTP
Telephone Number : 316-775-1415
Provider Enumeration Date : 09/29/2020
Last Update Date : 04/25/2024

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Directions to “TERASPOT, LLC ” Practice Location

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