Provider Demographics
NPI:1952457400
Name:VANG-FREELING, TERESA LYNN (LICSW, LIMHP)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:LYNN
Last Name:VANG-FREELING
Suffix:
Gender:F
Credentials:LICSW, LIMHP
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 5946
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68802-5946
Mailing Address - Country:US
Mailing Address - Phone:308-385-8674
Mailing Address - Fax:308-675-1558
Practice Address - Street 1:4224 SHANNA ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-2901
Practice Address - Country:US
Practice Address - Phone:308-385-8674
Practice Address - Fax:308-675-1558
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE832101YM0800X
NE3010101YM0800X
NE11931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health