Lacie Marie Teal
Social Worker, Clinical in Wapello, IA. Individual provider (NPI-1).
NPI number1114647666
StatusActive
Last updated in NPPESJun 11, 2025
Details
- NPI
- 1114647666
- Entity type
- Individual (NPI-1)
- Name
- Lacie Marie Teal
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 2, 2022
- Certification date
- Jun 11, 2025
- Last updated
- Jun 11, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – |
Practice location
304 Highway 61 NWapello, IA 52653-1243
Phone 319-523-8436 · Fax 319-523-7079
Mailing address
304 Highway 61 NWapello, IA 52653-1243
Phone 319-523-8436 · Fax 319-523-7079
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Clinical Social Worker providers in Wapello, IA
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