Individual
STEPHENIE TEAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
700 MASSACHUSETTS AVE FL 3, CAMBRIDGE, MA 02139-3345
(888) 500-2067
Mailing address
501 DEER TRL, CARBONDALE, IL 62901-5246
(916) 690-0558
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.015931
IL
101YP2500X
Professional Counselor
180015931
IL
104100000X
Social Worker
150.105200
IL
Other
Enumeration date
02/10/2016
Last updated
03/07/2025
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