Provider Demographics
NPI:1629781018
Name:SUTTON, TERRI JOANN (LPCA)
Entity Type:Individual
Prefix:MS
First Name:TERRI
Middle Name:JOANN
Last Name:SUTTON
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 SE BRITTON AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-6952
Mailing Address - Country:US
Mailing Address - Phone:503-360-8020
Mailing Address - Fax:
Practice Address - Street 1:113 N ELM ST
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-3519
Practice Address - Country:US
Practice Address - Phone:503-372-5147
Practice Address - Fax:503-266-8632
Is Sole Proprietor?:No
Enumeration Date:2022-12-30
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR8257101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health