Provider Demographics
NPI:1164534772
Name:COTE, TERESA (MA)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:COTE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12641 ANTIOCH RD STE 1037
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1701
Mailing Address - Country:US
Mailing Address - Phone:484-678-0552
Mailing Address - Fax:866-226-9940
Practice Address - Street 1:12641 ANTIOCH RD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1701
Practice Address - Country:US
Practice Address - Phone:484-678-0552
Practice Address - Fax:866-226-9940
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2458101YM0800X
FLMH21179101YM0800X
MO2016003030101YM0800X
PAPC004020101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA834621000OtherKEYSTONE
PA2701689000OtherIBC