Provider Demographics
NPI:1205012804
Name:TEEMANT, ROSS (LCSW)
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:
Last Name:TEEMANT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 W RANDOL MILL RD
Mailing Address - Street 2:# 200
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-3159
Mailing Address - Country:US
Mailing Address - Phone:817-253-9378
Mailing Address - Fax:
Practice Address - Street 1:1414 W RANDOL MILL RD
Practice Address - Street 2:# 200
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-3159
Practice Address - Country:US
Practice Address - Phone:817-253-9378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2008-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX384011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical