Provider Demographics
NPI:1114986643
Name:KINGFIELD, TERESA MARIE (LCSW C)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:MARIE
Last Name:KINGFIELD
Suffix:
Gender:F
Credentials:LCSW C
Other - Prefix:MS
Other - First Name:TERESA
Other - Middle Name:MARIE
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:153 PINGLEY LN
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-2202
Mailing Address - Country:US
Mailing Address - Phone:240-855-1837
Mailing Address - Fax:
Practice Address - Street 1:9912 MAYFIELD DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1652
Practice Address - Country:US
Practice Address - Phone:240-855-1837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07110104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD07110OtherBOARD OF SOCIAL WORK EXAM