MEDICARE: ARDANA R TEATE LCDC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	17662	TX

General Provider Information

NPI Number	:	1841143104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARDANA R TEATE LCDC

Provider Business Mailing Address
First Line	:	3212 CONCORD ST STE C
Second Line	:
City	:	ORANGE
State	:	TX
Zip	:	77630-2981
Country	:	US
Telephone Number	:	409-548-2751
Fax Number	:

Provider Business Practice Location Address
First Line	:	3212 CONCORD ST STE C
Second Line	:
City	:	ORANGE
State	:	TX
Zip	:	77630-2981
Country	:	US
Telephone Number	:	409-548-2751
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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Directions to “ ARDANA R TEATE LCDC” Practice Location

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