Provider Demographics
NPI:1629613427
Name:TERRY, KATELYN (LPCC)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:TERRY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 DENNISON AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3497
Mailing Address - Country:US
Mailing Address - Phone:614-233-1175
Mailing Address - Fax:
Practice Address - Street 1:1020 DENNISON AVE STE 101
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-3497
Practice Address - Country:US
Practice Address - Phone:614-233-1175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-15
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2404146101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health