Provider Demographics
NPI:1154967305
Name:RACHEL TEAGLE LPC INC
Entity type:Organization
Organization Name:RACHEL TEAGLE LPC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:TEAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-298-4963
Mailing Address - Street 1:7364 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-5184
Mailing Address - Country:US
Mailing Address - Phone:757-298-4963
Mailing Address - Fax:
Practice Address - Street 1:17389 PARHAM LANDING CT STE 10
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:VA
Practice Address - Zip Code:23181-9488
Practice Address - Country:US
Practice Address - Phone:804-843-7164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty