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Individual

MS. TERESA A. KEY-PICIUCCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PYSCH ASSISTANT

Contact information

Practice address
68 W CHURCH ST STE 318, NEWARK, OH 43055-5050
(740) 281-1777
(740) 281-1778
Mailing address
68 W CHURCH ST STE 318, NEWARK, OH 43055-5050
(740) 281-1777
(740) 281-1778

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YP2500X
Professional Counselor
1291
WV
103TC0700X
Clinical Psychologist
821
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0005456001
WV
01
001719061
MSBCBS SERVICE ID
WV
01
2171255
CIGNA ID NUMBER
WV
01
588982000
MAGELLAN MIS NUMBER
WV
01
Y01291
HEALTH PLAN ID
WV
Enumeration date
12/11/2006
Last updated
04/29/2025
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