Provider Demographics
NPI:1205064276
Name:ALLEN, TERESA LYNN (MED, LPCC)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:LYNN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MED, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 E MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-2262
Mailing Address - Country:US
Mailing Address - Phone:513-292-3753
Mailing Address - Fax:
Practice Address - Street 1:461 E MULBERRY ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-2262
Practice Address - Country:US
Practice Address - Phone:513-292-3753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-29
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health