Provider Demographics
NPI:1972961548
Name:ALLEN, TERESA K (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:K
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:974 ENGLISH HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROARING BRANCH
Mailing Address - State:PA
Mailing Address - Zip Code:17765-8929
Mailing Address - Country:US
Mailing Address - Phone:570-673-8398
Mailing Address - Fax:
Practice Address - Street 1:974 ENGLISH HILL RD
Practice Address - Street 2:
Practice Address - City:ROARING BRANCH
Practice Address - State:PA
Practice Address - Zip Code:17765-8929
Practice Address - Country:US
Practice Address - Phone:570-673-8398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008186101Y00000X, 101YS0200X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst