Provider Demographics
NPI:1013576446
Name:FLINT, TERRENCE B (LPC)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:B
Last Name:FLINT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 SHORE CLUB DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1566
Mailing Address - Country:US
Mailing Address - Phone:734-778-4706
Mailing Address - Fax:
Practice Address - Street 1:100 NB GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-2301
Practice Address - Country:US
Practice Address - Phone:586-783-2950
Practice Address - Fax:586-690-4333
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401018224101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor