Provider Demographics
NPI:1073136867
Name:YORK, TERRANCE LEE (LGSW)
Entity Type:Individual
Prefix:MR
First Name:TERRANCE
Middle Name:LEE
Last Name:YORK
Suffix:
Gender:M
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6515 BELCREST RD APT 1004C
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-2010
Mailing Address - Country:US
Mailing Address - Phone:910-280-8052
Mailing Address - Fax:
Practice Address - Street 1:2000 P ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5915
Practice Address - Country:US
Practice Address - Phone:410-961-7192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG50083221104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker