Provider Demographics
NPI:1376898619
Name:TERRY, AMY BETH (MA, LPC-I)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:BETH
Last Name:TERRY
Suffix:
Gender:F
Credentials:MA, LPC-I
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:BETH
Other - Last Name:EDGERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:58646 MCNUTTY WAY
Mailing Address - Street 2:
Mailing Address - City:ST. HELENS
Mailing Address - State:OR
Mailing Address - Zip Code:97051
Mailing Address - Country:US
Mailing Address - Phone:503-397-5211
Mailing Address - Fax:
Practice Address - Street 1:58646 MCNUTTY WAY
Practice Address - Street 2:
Practice Address - City:ST. HELENS
Practice Address - State:OR
Practice Address - Zip Code:97051
Practice Address - Country:US
Practice Address - Phone:503-397-5211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator