Healthcare Provider Details

I. General information

NPI: 1114081221
Provider Name (Legal Business Name): AARON KELLY TEAGUE MA, NCC, LPC, MT-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 11/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7115 CHURCH AVE.
PITTSBURGH PA
15202
US

IV. Provider business mailing address

7115 CHURCH AVE.
PITTSBURGH PA
15202
US

V. Phone/Fax

Practice location:
  • Phone: 412-761-0751
  • Fax: 412-766-5039
Mailing address:
  • Phone: 412-761-0751
  • Fax: 412-766-5039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC006307
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: