Provider Demographics
NPI:1588702252
Name:CARPENTIER-TEAGUE, SHEILA (MA)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:CARPENTIER-TEAGUE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 COUNTY ROAD 943
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35057-5987
Mailing Address - Country:US
Mailing Address - Phone:256-775-6370
Mailing Address - Fax:
Practice Address - Street 1:1909 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-6151
Practice Address - Country:US
Practice Address - Phone:256-734-4688
Practice Address - Fax:256-736-5638
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51542890OtherBLUE CROSS BLUE SHIELD