Provider Demographics
NPI:1568114403
Name:TUFTS, TERRANCE (LPC)
Entity Type:Individual
Prefix:
First Name:TERRANCE
Middle Name:
Last Name:TUFTS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 N HEATHERWILDE BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-4195
Mailing Address - Country:US
Mailing Address - Phone:512-704-8349
Mailing Address - Fax:512-693-4006
Practice Address - Street 1:8700 MENCHACA RD STE 303
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5374
Practice Address - Country:US
Practice Address - Phone:512-704-8349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82720101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional