Provider Demographics
NPI:1043270713
Name:TERPSTRA, DAVID (MED LPC LMFT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:TERPSTRA
Suffix:
Gender:M
Credentials:MED LPC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 141073
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-1073
Mailing Address - Country:US
Mailing Address - Phone:214-354-3648
Mailing Address - Fax:
Practice Address - Street 1:530 S CARRIER PARKWAY
Practice Address - Street 2:STE 397
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051
Practice Address - Country:US
Practice Address - Phone:214-354-3648
Practice Address - Fax:214-824-0414
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14790101YP2500X
TX106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist