Provider Demographics
NPI:1629133905
Name:TERRY, SCOTT F (EDD, LMFT, LCPC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:F
Last Name:TERRY
Suffix:
Gender:M
Credentials:EDD, LMFT, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:684 S BARRINGTON RD
Mailing Address - Street 2:STE 112
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-1841
Mailing Address - Country:US
Mailing Address - Phone:641-233-8273
Mailing Address - Fax:847-349-1619
Practice Address - Street 1:684 S BARRINGTON RD
Practice Address - Street 2:STE 112
Practice Address - City:STREAMWOOD
Practice Address - State:IL
Practice Address - Zip Code:60107-1841
Practice Address - Country:US
Practice Address - Phone:641-233-8273
Practice Address - Fax:847-349-1619
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006449101YM0800X
IL166.000736106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180.006449OtherLCPC