Provider Demographics
NPI:1215264858
Name:TEEL, TREV (LPC)
Entity type:Individual
Prefix:
First Name:TREV
Middle Name:
Last Name:TEEL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4210 CRESTEDGE LN
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4103
Mailing Address - Country:US
Mailing Address - Phone:972-492-5479
Mailing Address - Fax:973-201-3102
Practice Address - Street 1:4210 CRESTEDGE LN
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4103
Practice Address - Country:US
Practice Address - Phone:972-492-5479
Practice Address - Fax:973-201-3102
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65740101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional