Provider Demographics
NPI:1396298238
Name:TEEL, EMILY SAGE (MAMFT)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:SAGE
Last Name:TEEL
Suffix:
Gender:F
Credentials:MAMFT
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:SAGE
Other - Last Name:NEWMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:2716 GASTON LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-6989
Mailing Address - Country:US
Mailing Address - Phone:760-846-6487
Mailing Address - Fax:
Practice Address - Street 1:780 LYNNHAVEN PKWY STE 400
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7332
Practice Address - Country:US
Practice Address - Phone:757-694-4723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health