Provider Demographics
NPI:1013372739
Name:HATHERLEY, TERRY G (MS, LPC)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:G
Last Name:HATHERLEY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ROCKMEAD DR STE 132
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2197
Mailing Address - Country:US
Mailing Address - Phone:713-481-2808
Mailing Address - Fax:713-481-2805
Practice Address - Street 1:800 ROCKMEAD DR STE 132
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2197
Practice Address - Country:US
Practice Address - Phone:713-481-2808
Practice Address - Fax:713-481-2805
Is Sole Proprietor?:No
Enumeration Date:2015-12-22
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71072101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional