Provider Demographics
NPI:1902149628
Name:SLYE, TERESA FREEMAN (LPCA)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:FREEMAN
Last Name:SLYE
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:SLYE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCA
Mailing Address - Street 1:33 SHARON LYNNE WAY
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-8285
Mailing Address - Country:US
Mailing Address - Phone:828-452-1300
Mailing Address - Fax:828-627-1307
Practice Address - Street 1:33 SHARON LYNNE WAY
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-8285
Practice Address - Country:US
Practice Address - Phone:828-452-1300
Practice Address - Fax:828-627-1307
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-01
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9942101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health