Provider Demographics
NPI:1629738919
Name:STREETER, TERENCE MAURICE (CADC 16603)
Entity Type:Individual
Prefix:
First Name:TERENCE
Middle Name:MAURICE
Last Name:STREETER
Suffix:
Gender:M
Credentials:CADC 16603
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 HENDERSONVILLE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1753
Mailing Address - Country:US
Mailing Address - Phone:828-350-9960
Mailing Address - Fax:828-350-9916
Practice Address - Street 1:900 HENDERSONVILLE RD STE 203
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1753
Practice Address - Country:US
Practice Address - Phone:828-350-9960
Practice Address - Fax:828-350-9916
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16603101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)