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General NPI Number Information
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NPI Number | 1700097672
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Entity Type | Individual
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Provider Name | MICHAEL H. TEAGUE MSW, LADAC, LMSW,
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Gender | Male
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2913 KING ST SUITE 4
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City | JONESBORO
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State | AR
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Zip | 72401-5322
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Country | US
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Telephone | 870-972-6199
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Fax | 870-972-6199
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Provider Business Mailing Address
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Address Line | PO BOX 10040
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City | JONESBORO
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State | AR
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Zip | 72401-1140
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Country | US
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Telephone | 870-972-6199
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Fax | 870-972-6199
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0006-L
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 758-M
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License Number State | AR
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