Provider Demographics
NPI:1417948845
Name:CESELSKI, TERESA A (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:A
Last Name:CESELSKI
Suffix:
Gender:F
Credentials:MS, LPC
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 814
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MO
Mailing Address - Zip Code:65340-0814
Mailing Address - Country:US
Mailing Address - Phone:660-831-1766
Mailing Address - Fax:660-831-1766
Practice Address - Street 1:1701 S MIAMI AVE
Practice Address - Street 2:302
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-3231
Practice Address - Country:US
Practice Address - Phone:660-831-1766
Practice Address - Fax:660-831-1766
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health