Provider Demographics
NPI:1497056006
Name:KLINGELHOEFER, TERRI S (MSW)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:S
Last Name:KLINGELHOEFER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 16TH ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421-3003
Mailing Address - Country:US
Mailing Address - Phone:812-275-4053
Mailing Address - Fax:812-275-5494
Practice Address - Street 1:PO BOX 553
Practice Address - Street 2:
Practice Address - City:LINTON
Practice Address - State:IN
Practice Address - Zip Code:47441-0553
Practice Address - Country:US
Practice Address - Phone:812-847-4435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-12
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99044244A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical