1831586213 NPI number — AMERICANWORK, LLC

Table of content: JULIE ANN TEUBER MA. LMHCA (NPI 1164010302)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831586213 NPI number — AMERICANWORK, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICANWORK, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831586213
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1727 WRIGHTSBORO RD STE B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUGUSTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30904-4049
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
912-638-0350
Provider Business Mailing Address Fax Number:
706-736-8184

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 18TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31901-1504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-641-9663
Provider Business Practice Location Address Fax Number:
706-641-9662
Provider Enumeration Date:
04/23/2015

Additional Information

Authorized Official

Authorized Official Last Name:
WATERS
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
706-200-8677

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000902063AR , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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