Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Teresa Wiedemann, LICSW

Individual provider Clinical Social Worker · NPI 1063790509

MS. Teresa Wiedemann, LICSW is a Clinical Social Worker in Walla Walla, Washington. Practices as a sole proprietor. Licensed in Washington.

Licensed in
WA
In the registry since
2011
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

139 Russet Rd
Walla Walla, WA 99362-8253
Phone: (509) 520-4370
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LW 60111377 (WA)

Record details

NPI number1063790509
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedAugust 2, 2011
Last updated in NPPESApril 9, 2012

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