Provider Demographics
NPI:1265047823
Name:ALTEMUS, TEREAL JYVON (CCSW)
Entity type:Individual
Prefix:MS
First Name:TEREAL
Middle Name:JYVON
Last Name:ALTEMUS
Suffix:
Gender:F
Credentials:CCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 IVY CT
Mailing Address - Street 2:
Mailing Address - City:RESERVE
Mailing Address - State:LA
Mailing Address - Zip Code:70084-5520
Mailing Address - Country:US
Mailing Address - Phone:504-858-9848
Mailing Address - Fax:
Practice Address - Street 1:3345 HANS AVE APT F
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-3857
Practice Address - Country:US
Practice Address - Phone:504-858-9848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator