Provider Demographics
NPI:1083048524
Name:TERRY, ELAINA RASHID (MA, LPC)
Entity Type:Individual
Prefix:
First Name:ELAINA
Middle Name:RASHID
Last Name:TERRY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2227 BAYSWATER DR
Mailing Address - Street 2:
Mailing Address - City:CREEDMOOR
Mailing Address - State:NC
Mailing Address - Zip Code:27522-7837
Mailing Address - Country:US
Mailing Address - Phone:252-425-7527
Mailing Address - Fax:
Practice Address - Street 1:116 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:CREEDMOOR
Practice Address - State:NC
Practice Address - Zip Code:27522-9747
Practice Address - Country:US
Practice Address - Phone:252-425-7527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-31
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10123101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health