Kelly A. Teague, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801077026 Issued in MI

Practice address

6637 Highland Rd
Waterford, MI 48327-1675

Phone

(248) 666-8870

NPI assigned

May 31, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1023055936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8006 CRESCENT DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483483939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6637 HIGHLAND RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271675",
            "telephone_number": "248-666-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAGUE",
        "first_name": "KELLY",
        "middle_name": "A.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801077026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Targosz, CNP
• Marco Antonio Tauil, DDS
• Charles Ka Ua Taylor-Fulton
• Marvin S Taylor, DDS
• Maxine Taylor
• Teamwork Home Care, LLC
• Kailey Allison Temple, FNP-BC
• Carole Ann Tennis
• Thabet Abbarah MD ENT PC
• Steven Tharrett, PT

• Clinical Social Worker in Waterford, MI
• Providers in Waterford, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.