Provider Demographics
NPI:1407031974
Name:SHEILA TEITELBAUM, PSYD, LLC
Entity Type:Organization
Organization Name:SHEILA TEITELBAUM, PSYD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TEITELBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:303-759-3580
Mailing Address - Street 1:4900 CHERRY CREEK SOUTH DR
Mailing Address - Street 2:#4
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2283
Mailing Address - Country:US
Mailing Address - Phone:303-759-3580
Mailing Address - Fax:
Practice Address - Street 1:4900 CHERRY CREEK SOUTH DR
Practice Address - Street 2:#4
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-2283
Practice Address - Country:US
Practice Address - Phone:303-759-3580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1351103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty