Provider Demographics
NPI:1164166450
Name:HARRELL, TERIKA (LMHC)
Entity Type:Individual
Prefix:
First Name:TERIKA
Middle Name:
Last Name:HARRELL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:968 GLEASON CIR
Mailing Address - Street 2:
Mailing Address - City:E ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14445-2355
Mailing Address - Country:US
Mailing Address - Phone:315-450-0973
Mailing Address - Fax:
Practice Address - Street 1:200 WHITE SPRUCE BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1605
Practice Address - Country:US
Practice Address - Phone:585-210-8782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-23
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012375101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health