Provider Demographics
NPI:1528865425
Name:HONSHELL, TEAGAN NICOLE (PRS, CDCAI)
Entity type:Individual
Prefix:
First Name:TEAGAN
Middle Name:NICOLE
Last Name:HONSHELL
Suffix:
Gender:F
Credentials:PRS, CDCAI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3008 SUDBURY DR
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45420-1129
Mailing Address - Country:US
Mailing Address - Phone:937-310-1269
Mailing Address - Fax:937-310-1199
Practice Address - Street 1:3008 SUDBURY DR
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45420-1129
Practice Address - Country:US
Practice Address - Phone:937-310-1269
Practice Address - Fax:937-310-1199
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.191471101YA0400X
OHAPS.005715175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)