Provider Demographics
NPI:1568795870
Name:FAULKNER, TERESA J (MSW)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:J
Last Name:FAULKNER
Suffix:
Gender:F
Credentials:MSW
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 769
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47547-0769
Mailing Address - Country:US
Mailing Address - Phone:812-482-3020
Mailing Address - Fax:812-482-6409
Practice Address - Street 1:523 N. MAIN STREET
Practice Address - Street 2:
Practice Address - City:ENGLISH
Practice Address - State:IN
Practice Address - Zip Code:47118-0400
Practice Address - Country:US
Practice Address - Phone:812-338-2756
Practice Address - Fax:812-338-2490
Is Sole Proprietor?:No
Enumeration Date:2009-09-18
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical