Provider Demographics
NPI:1639883747
Name:TEOLI-PHELPS, BROOK ELAINE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:BROOK
Middle Name:ELAINE
Last Name:TEOLI-PHELPS
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 1:1625 RUTHERFORD LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-5173
Mailing Address - Country:US
Mailing Address - Phone:512-651-6150
Mailing Address - Fax:
Practice Address - Street 1:1625 RUTHERFORD LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-5173
Practice Address - Country:US
Practice Address - Phone:512-651-6150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106919104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker