Provider Demographics
NPI:1295827368
Name:HARPER, TERRI ANNE (LMHC)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:ANNE
Last Name:HARPER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:ANNE
Other - Last Name:VAN BENTHUYSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:1207 MANDARIN LN
Mailing Address - Street 2:
Mailing Address - City:FRUITLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:34731-3409
Mailing Address - Country:US
Mailing Address - Phone:352-315-7100
Mailing Address - Fax:352-360-6582
Practice Address - Street 1:4400 N HIGHWAY 19A STE 5
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-2022
Practice Address - Country:US
Practice Address - Phone:452-357-1955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008220500Medicaid