Wandalyn Isaac Teague, LPC/NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

NCC# 95559 Issued in NC

Practice address

900 Roanoke St
Scotland Neck, NC 27874

Phone

(252) 826-0188

NPI assigned

Mar 17, 2008

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1992976054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ROANOKE ST",
            "city": "SCOTLAND NECK",
            "state": "NC",
            "postal_code": "278741236",
            "telephone_number": "252-826-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 ROANOKE ST",
            "city": "SCOTLAND NECK",
            "state": "NC",
            "postal_code": "27874",
            "telephone_number": "252-826-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAGUE",
        "first_name": "WANDALYN",
        "middle_name": "ISAAC",
        "name_prefix": "Mrs.",
        "credential": "LPC/NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-17",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "NCC# 95559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rural Health Group, Inc. (Rural Health Group at Scotland Neck)
• Scotland Neck Family Medical Center, Inc.
• Scotland Neck NC Opco LLC (Scotland Manor Health and Rehabilitation Center)
• Christopher A Smith, PHARM.D
• Susan Bullard Staton, P.T.
• United Medical Supplies Inc
• United Services Group Inc
• Latara Wade, PTA
• Wescare Professional Services, LLC.
• Chester Bruce Williams

• Mental Health Counselor in Scotland Neck, NC
• Providers in Scotland Neck, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.