Provider Demographics
NPI:1386230837
Name:TEASLEY, KASEY (LPCC)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:
Last Name:TEASLEY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:AR
Mailing Address - Zip Code:72006-0497
Mailing Address - Country:US
Mailing Address - Phone:870-347-2534
Mailing Address - Fax:
Practice Address - Street 1:120 N 4TH ST
Practice Address - Street 2:
Practice Address - City:BARLOW
Practice Address - State:KY
Practice Address - Zip Code:42024-9579
Practice Address - Country:US
Practice Address - Phone:270-334-3131
Practice Address - Fax:270-334-3173
Is Sole Proprietor?:No
Enumeration Date:2020-12-18
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
KY286941101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)