Provider Demographics
NPI:1174541940
Name:TEER, JOHN PAUL (LCSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PAUL
Last Name:TEER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 HILL ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7423
Mailing Address - Country:US
Mailing Address - Phone:336-601-2264
Mailing Address - Fax:336-273-2404
Practice Address - Street 1:1208 HILL ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7423
Practice Address - Country:US
Practice Address - Phone:336-601-2264
Practice Address - Fax:336-273-2404
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0011121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003208Medicaid
NC6003208Medicaid