Provider Demographics
NPI:1700060829
Name:TEPLIN, CAROL M (MPS)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:M
Last Name:TEPLIN
Suffix:
Gender:F
Credentials:MPS
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:BALL
Other - Last Name:TEPLIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MPS
Mailing Address - Street 1:32 JAY STREET
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801
Mailing Address - Country:US
Mailing Address - Phone:516-474-9344
Mailing Address - Fax:
Practice Address - Street 1:32 JAY STREET
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801
Practice Address - Country:US
Practice Address - Phone:516-474-9344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003254101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health