Teague Psychological Services, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

20040735 Issued in IN

Legal business name

TEAGUE PSYCHOLOGICAL SERVICES, INC.

Practice address

6470 N. Shadeland
Suite C
Indianapolis, IN 46220

Phone

(317) 849-9509

Fax

(317) 841-1157

NPI assigned

Jan 11, 2012

Last updated

Jan 11, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James Bradley Teague, PHDNPI 1821098922

Title

President

Phone

(317) 849-9509

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Bradley Teague, PH.D.

  • Clinical Psychologist
  • Indianapolis, IN
  • NPI 1821098922
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1063782803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6470 N. SHADELAND",
            "address_2": "SUITE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46220",
            "telephone_number": "317-849-9509",
            "fax_number": "317-841-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6470 N. SHADELAND",
            "address_2": "SUITE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46220",
            "telephone_number": "317-849-9509",
            "fax_number": "317-841-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEAGUE PSYCHOLOGICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-849-9509",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IN",
            "license": "20040735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100216740",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karson Riley Tays, RBT
• Fadi Taza, MD
• Sarah A Taza, PA
• Dmitriy Sergeevick Tckachenko, MD
• Sharon Lou Teagardin, MSW, LCSW, LMFT
• Devieon Teague
• James Bradley Teague, PH.D.
• Kristie Lee Teague, BS
• Latosha Rene Teague
• Shawn D Teague, MD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.