Provider Demographics
NPI:1447804299
Name:MATTHEWS, TEELYE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:TEELYE
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6944 W LAVERNE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-2509
Mailing Address - Country:US
Mailing Address - Phone:504-579-6500
Mailing Address - Fax:
Practice Address - Street 1:1799 STUMPF BLVD STE 10
Practice Address - Street 2:
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-3950
Practice Address - Country:US
Practice Address - Phone:504-266-2522
Practice Address - Fax:504-308-1400
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10676171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty