TERESIA MORTENSON (MSW, LICSW) – Clinical Social Worker, NPI 1811775968

TERESIA MORTENSON (MSW, LICSW) is a healthcare provider. based in Crosslake, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials MSW, LICSW. They hold a License No. 9728 (MN). The NPI Number for TERESIA MORTENSON (MSW, LICSW) is 1811775968

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
TERESIA MORTENSON (MSW, LICSW)
NPI
1811775968
Phone
(218) 839-2869
Address
14399 ANDERSEN DR
Enumeration Date
19 September 2023
Last Update Date
19 September 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2184543288
Graduation Year
2019 (7 years ago)
PAC ID
0749625945
Group Practice PAC ID
7618383951
Professional Enrollment ID
I20240227004132
Address ID
MN564013970BR401XXSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for TERESIA MORTENSON (MSW, LICSW)

  • 14399 ANDERSEN DR

    CROSSLAKE, MN 564423500

    Phone: (218) 839-2869

    Type: Mailing

  • 401 W LAUREL ST STE C

    BRAINERD, MN 564013970

    Phone: (218) 454-3288

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240227004132IClinical Social WorkerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 56442)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7618383951View full group profile
NameSpecialtyState
Mental Health CounselorMN
Marriage And Family TherapistMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Marriage And Family TherapistMN

Reviews

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Frequently asked questions

Does TERESIA MORTENSON (MSW, LICSW) have a public NPI I can cite?
Public records show TERESIA MORTENSON (MSW, LICSW) under NPI 1811775968.
Should I treat TERESIA MORTENSON (MSW, LICSW) as an active provider?
Patients and plans typically see TERESIA MORTENSON (MSW, LICSW) as active in the national extract.
Which specialty label fits TERESIA MORTENSON (MSW, LICSW)?
NPPES ties TERESIA MORTENSON (MSW, LICSW) to Clinical Social Worker in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to TERESIA MORTENSON (MSW, LICSW)?
The directory associates TERESIA MORTENSON (MSW, LICSW) with Crosslake, Minnesota. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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