Lacie Marie Teal

Key facts

NPI

1114647666

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

Practice address

304 Highway 61 N
Wapello, IA 52653-1243

Phone

(319) 523-8436

Fax

(319) 523-7079

NPI assigned

Sep 2, 2022

Sex

Female

Sole proprietor

No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alcohol & Drug Dependency Services Substance Abuse Rehabilitation Facility · Wapello, IA · NPI 1043486400
  NPD (past)
• Optimae Lifeservices, Inc, Community/Behavioral Health Agency · Fairfield, IA · NPI 1174520084
  NPD (past) CLINICAL

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Specialties & licenses

Addresses

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 11, 2025.

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1114647666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 HIGHWAY 61 N",
            "city": "WAPELLO",
            "state": "IA",
            "postal_code": "526531243",
            "telephone_number": "319-523-8436",
            "fax_number": "319-523-7079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 HIGHWAY 61 N",
            "city": "WAPELLO",
            "state": "IA",
            "postal_code": "526531243",
            "telephone_number": "319-523-8436",
            "fax_number": "319-523-7079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAL",
        "first_name": "LACIE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-02",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "lteal@addsiowa.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "304 Highway 61 N",
            "city": "Wapello",
            "state": "IA",
            "country_code": "US",
            "postal_code": "526531243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wapello, IA

• Rescare, Inc
• Peter William Smillie, CADC
• State University of Iowa
• Stepping Stones Caregiving
• Michelle Lee Sutton
• Teresa M Theobald, D.C.
• University of Iowa Community Medical Services, Inc
• Wapello Community School District

All providers in Wapello, IA · Clinical Social Worker in Iowa