Provider Demographics
NPI:1164403200
Name:HOSKINS, TERESA C (LCSW)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:C
Last Name:HOSKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W WORLEY ST
Mailing Address - Street 2:FAMILY HEALTH CENTER
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-2037
Mailing Address - Country:US
Mailing Address - Phone:573-214-2314
Mailing Address - Fax:573-814-2784
Practice Address - Street 1:1001 W WORLEY ST
Practice Address - Street 2:FAMILY HEALTH CENTER
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-2037
Practice Address - Country:US
Practice Address - Phone:573-214-2314
Practice Address - Fax:573-814-2784
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0009721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP09406Medicare UPIN