Provider Demographics
NPI:1710618061
Name:KRIEGSMAN, TEDDI (RMHCI)
Entity type:Individual
Prefix:MRS
First Name:TEDDI
Middle Name:
Last Name:KRIEGSMAN
Suffix:
Gender:F
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38223 FALLSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-5984
Mailing Address - Country:US
Mailing Address - Phone:860-806-6345
Mailing Address - Fax:
Practice Address - Street 1:15311 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-6005
Practice Address - Country:US
Practice Address - Phone:352-540-9335
Practice Address - Fax:352-467-7157
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4834101YP2500X
FLIMH25735101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4834OtherSTATE OF CT DPH
FLIMH25735OtherSTATE OF FL DPH