Provider Demographics
NPI:1114171691
Name:PIERCE, TERRENCE K (CAC)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:K
Last Name:PIERCE
Suffix:
Gender:M
Credentials:CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4015 S COBB DR SE STE 220
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6316
Mailing Address - Country:US
Mailing Address - Phone:770-801-0980
Mailing Address - Fax:770-801-9039
Practice Address - Street 1:4015 S COBB DR SE STE 220
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6316
Practice Address - Country:US
Practice Address - Phone:770-801-0980
Practice Address - Fax:770-801-9039
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)