MEDICARE: MS. MICHELE STEPANEK TEAGUE MSW

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	101YM0800X	Mental Health Counselor	99122959A	IN

General Provider Information

NPI Number	:	1477303527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELE STEPANEK TEAGUE MSW

Provider Business Mailing Address
First Line	:	8090 SHALDON CT
Second Line	:
City	:	ZIONSVILLE
State	:	IN
Zip	:	46077-7980
Country	:	US
Telephone Number	:	317-748-4200
Fax Number	:

Provider Business Practice Location Address
First Line	:	9650 COMMERCE DR STE 521
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46032-7639
Country	:	US
Telephone Number	:	317-748-4200
Fax Number	:

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

Provider Enumeration Date	:	03/22/2024
Last Update Date	:	03/22/2024

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