Provider Demographics
NPI:1114081221
Name:TEAGUE, AARON KELLY (MA, NCC, LPC, MT-BC)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:KELLY
Last Name:TEAGUE
Suffix:
Gender:M
Credentials:MA, NCC, LPC, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7115 CHURCH AVE.
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15202
Mailing Address - Country:US
Mailing Address - Phone:412-761-0751
Mailing Address - Fax:412-766-5039
Practice Address - Street 1:7115 CHURCH AVE.
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15202
Practice Address - Country:US
Practice Address - Phone:412-761-0751
Practice Address - Fax:412-766-5039
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006307101YP2500X
225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist