Healthcare Provider Details

I. General information

NPI: 1083736607
Provider Name (Legal Business Name): KATHLEEN NADEAU PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHLEEN NADEAU TEEGARDEN PH.D.

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 WILLARD AVE APT 1235
CHEVY CHASE MD
20815-4627
US

IV. Provider business mailing address

4701 WILLARD AVE APT 1235
CHEVY CHASE MD
20815-4627
US

V. Phone/Fax

Practice location:
  • Phone: 301-404-5186
  • Fax:
Mailing address:
  • Phone: 301-404-5186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1188
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: