Provider Demographics
NPI:1427898154
Name:TERESA WELCH, LICENSED PSYCHOLOGIST, LLC
Entity type:Organization
Organization Name:TERESA WELCH, LICENSED PSYCHOLOGIST, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-777-0505
Mailing Address - Street 1:965 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-2803
Mailing Address - Country:US
Mailing Address - Phone:814-357-7755
Mailing Address - Fax:678-882-3119
Practice Address - Street 1:965 GREEN ST
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-2803
Practice Address - Country:US
Practice Address - Phone:814-357-7755
Practice Address - Fax:678-882-3119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-30
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health