Provider Demographics
NPI:1467758086
Name:CORREIA, TERESA (PSYD)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:
Last Name:CORREIA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 AUCKLAND WAY
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21619-2293
Mailing Address - Country:US
Mailing Address - Phone:571-969-2367
Mailing Address - Fax:
Practice Address - Street 1:1563 POSTAL RD STE 3D
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:MD
Practice Address - Zip Code:21619-2318
Practice Address - Country:US
Practice Address - Phone:571-210-5022
Practice Address - Fax:571-210-6012
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810005375103TC0700X, 103TC0700X
MD06377103T00000X
103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist