Provider Demographics
NPI:1558904037
Name:TESKA, COURTNEY (LMSW)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:TESKA
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 1:8 BRANWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-5710
Mailing Address - Country:US
Mailing Address - Phone:631-835-8668
Mailing Address - Fax:
Practice Address - Street 1:35 CROOKED HILL RD STE 203
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-5415
Practice Address - Country:US
Practice Address - Phone:631-835-8668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY107830104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker