Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tedra Lynn Hall, LICSW

Individual provider Clinical Social Worker · NPI 1700469087

Tedra Lynn Hall, LICSW is a Clinical Social Worker in Jamaica Plain, Massachusetts. Qualified in 2021, 5 years ago. Practices with Colony Care Inc, a 29-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
5
Licensed in
MA
In the registry since
2021
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

11 Green St
Jamaica Plain, MA 02130-2588
Phone: (800) 764-4806
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 11 River St, Wellesley, MA 02481-2017 — (781) 431-1177

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 128606 (MA)

Record details

NPI number1700469087
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedMay 4, 2021
Last updated in NPPESDecember 4, 2025
Certification dateDecember 4, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Colony Care Inc — 29 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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