MEDICARE: TERESA E SEWARD LISW

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
1	1041C0700X	Clinical Social Worker	C001703	NC
2	1041C0700X	Clinical Social Worker	00698	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	130E2	OTHER	NC	BLUECROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770502668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA E SEWARD LISW

Provider Business Mailing Address
First Line	:	301 W BURLINGTON
Second Line	:
City	:	FAIRFIELD
State	:	IA
Zip	:	52556-3242
Country	:	US
Telephone Number	:	828-697-6541
Fax Number	:	828-697-1929

Provider Business Practice Location Address
First Line	:	1730 1ST AVENUE EAST
Second Line	:
City	:	NEWTON
State	:	IA
Zip	:	50208-4049
Country	:	US
Telephone Number	:	641-275-3520
Fax Number	:	641-275-3500

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	11/16/2022

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Directions to “ TERESA E SEWARD LISW” Practice Location

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