Provider Demographics
NPI:1770502668
Name:SEWARD, TERESA E (LISW)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:E
Last Name:SEWARD
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W BURLINGTON
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52556-3242
Mailing Address - Country:US
Mailing Address - Phone:828-697-6541
Mailing Address - Fax:828-697-1929
Practice Address - Street 1:1730 1ST AVENUE EAST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208-4049
Practice Address - Country:US
Practice Address - Phone:641-275-3520
Practice Address - Fax:641-275-3500
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0017031041C0700X
IA006981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC130E2OtherBLUECROSS
NC6002177Medicaid
NC6002177Medicaid