Provider Demographics
NPI:1336653815
Name:PLEASANTS, TERRENCE LAMAR (LCSWA)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:LAMAR
Last Name:PLEASANTS
Suffix:
Gender:M
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 SEDONA LN
Mailing Address - Street 2:
Mailing Address - City:MC LEANSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27301-9801
Mailing Address - Country:US
Mailing Address - Phone:336-906-3345
Mailing Address - Fax:
Practice Address - Street 1:301 N ELM ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2083
Practice Address - Country:US
Practice Address - Phone:336-275-7973
Practice Address - Fax:336-272-1325
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP010714101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health