Provider Demographics
NPI:1659436327
Name:EHELER, TERRY LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TERRY
Middle Name:LYNN
Last Name:EHELER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 WATER AVE NW STE 400
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-2280
Mailing Address - Country:US
Mailing Address - Phone:541-928-8090
Mailing Address - Fax:541-928-6178
Practice Address - Street 1:213 WATER AVE NW STE 400
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2280
Practice Address - Country:US
Practice Address - Phone:541-928-8090
Practice Address - Fax:541-928-6178
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND112139Medicare ID - Type Unspecified