Northlake Medical Psychology and Counseling

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Mandeville, LA

NPI 1043692437 · NPPES record last updated Jul 29, 2015

Key facts

NPI
1043692437
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
License
MP.000036 (LA)
Legal business name
NORTHLAKE MEDICAL PSYCHOLOGY AND COUNSELING
Practice address
215 Saint Ann Dr Ste 2
Mandeville, LA 70471-3394
Phone
(601) 946-1844
NPI assigned
Jun 23, 2015
Organization subpart
No

Authorized official

Name
John A Teal, PHD, MP
Title
Medical Psychologist
Phone
(601) 946-1844

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

215 Saint Ann Dr
Ste 2
Mandeville, LA 70471
Phone (601) 946-1844

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X MP.000036 LA Yes
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X LPC #3492 LA
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X MP.0020 LA

Addresses

Primary practice location

215 Saint Ann Dr Ste 2
Mandeville, LA 70471-3394

Mailing address

215 Saint Ann Dr Ste 2
Mandeville, LA 70471-3394
Phone (601) 946-1844

Other providers in Mandeville, LA

All providers in Mandeville, LA · Mental Health Clinic/Center (Including Community Mental Health Center) in Louisiana

Sources for this page

Verify at the official NPI Registry.