Organization
TEAL GROUP PLLC
Active
Parent organization
UNITED MEDICAL GROUP BEHAVIORAL HEALTH
Other names
UNITED MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNITED MEDICAL GROUP BEHAVIORAL HEALTH
Authorized official
MS. SUZANNE FORD DO (PRESIDENT)
(606) 437-2400
Entity
Organization
Contact information
Practice address
50 WEDDINGTON BRANCH RD, PIKEVILLE, KY 41501-3296
(606) 437-2400
(606) 437-2401
Mailing address
258 NORTH LEVISA ROAD, MOUTHCARD, KY 41548-8331
(606) 437-2400
(606) 437-2401
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
103079
KY
101YP2500X
Professional Counselor
103079
KY
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
02802
KY
207QA0401X
Addiction Medicine (Family Medicine) Physician
02861
KY
363LF0000X
Family Nurse Practitioner
3009093
KY
Other
Enumeration date
02/09/2017
Last updated
11/05/2020
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