Provider Demographics
NPI:1285109538
Name:TEAL, SUBRAMONIANPILLAI (LCSW-C)
Entity type:Individual
Prefix:MR
First Name:SUBRAMONIANPILLAI
Middle Name:
Last Name:TEAL
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5026 CAMPBELL BLVD STE H
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-5051
Mailing Address - Country:US
Mailing Address - Phone:443-983-4652
Mailing Address - Fax:410-780-2694
Practice Address - Street 1:5026 CAMPBELL BLVD STE H
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-5051
Practice Address - Country:US
Practice Address - Phone:443-983-4652
Practice Address - Fax:410-780-2694
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health