Provider Demographics
NPI:1083159925
Name:ARMSTRONG, TERRY
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:
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 235
Mailing Address - Street 2:
Mailing Address - City:NORTH SALEM
Mailing Address - State:IN
Mailing Address - Zip Code:46165-0235
Mailing Address - Country:US
Mailing Address - Phone:765-721-0311
Mailing Address - Fax:
Practice Address - Street 1:202 W PEARL ST
Practice Address - Street 2:
Practice Address - City:NORTH SALEM
Practice Address - State:IN
Practice Address - Zip Code:46165-9552
Practice Address - Country:US
Practice Address - Phone:765-721-0311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-02
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33000634104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker