Individual
MR. PETER THOMAS TEALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW-R, CASAC
Contact information
Practice address
496 WHITE SPRUCE BLVD, ROCHESTER, NY 14623-1608
(585) 305-8759
Mailing address
496 WHITE SPRUCE BLVD, ROCHESTER, NY 14623-1608
(585) 305-8759
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11606
NY
101YM0800X
Mental Health Counselor
071006-1
NY
Other
Enumeration date
08/08/2006
Last updated
09/11/2025
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