Provider Demographics
NPI:1811296973
Name:TELLER, FRANK H (LCSW)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:H
Last Name:TELLER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1825 RIVERSIDE DR
Mailing Address - Street 2:CATHOLIC CHARITIES
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-2316
Mailing Address - Country:US
Mailing Address - Phone:920-272-8234
Mailing Address - Fax:920-437-4067
Practice Address - Street 1:1825 RIVERSIDE DR
Practice Address - Street 2:CATHOLIC CHARITIES
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-2316
Practice Address - Country:US
Practice Address - Phone:920-272-8234
Practice Address - Fax:920-437-4067
Is Sole Proprietor?:No
Enumeration Date:2011-03-15
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7913-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical