Healthcare Provider Details

I. General information

NPI: 1205606118
Provider Name (Legal Business Name): SARAH ELIZABETH TESCHENDORF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 W 2ND ST
ANNA TX
75409-3601
US

IV. Provider business mailing address

PO BOX 654
ANNA TX
75409-0654
US

V. Phone/Fax

Practice location:
  • Phone: 469-545-2719
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number94146
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC8290
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: