Provider Demographics
NPI:1689854168
Name:TERRES, SCOTT JON (LPC)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:JON
Last Name:TERRES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 N MOPAC EXPY
Mailing Address - Street 2:SUITE 820
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8375
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8500 N MOPAC EXPY
Practice Address - Street 2:SUITE 820
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8375
Practice Address - Country:US
Practice Address - Phone:512-671-9945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61372101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional