Provider Demographics
NPI:1679260442
Name:TERRELL, MAKEBA DE' (LPC)
Entity Type:Individual
Prefix:
First Name:MAKEBA
Middle Name:DE'
Last Name:TERRELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18623 RIMINI RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-6795
Mailing Address - Country:US
Mailing Address - Phone:832-483-8106
Mailing Address - Fax:
Practice Address - Street 1:18623 RIMINI RIDGE CT
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-6795
Practice Address - Country:US
Practice Address - Phone:832-483-8106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health