Provider Demographics
NPI:1467511485
Name:LODICO, TERRY LYNN (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:LYNN
Last Name:LODICO
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:212 W WACKERLY ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-3000
Mailing Address - Country:US
Mailing Address - Phone:989-835-8344
Mailing Address - Fax:989-837-8655
Practice Address - Street 1:3788 E MARILYNS LN
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-8885
Practice Address - Country:US
Practice Address - Phone:989-835-8344
Practice Address - Fax:989-835-8344
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006884101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional