Provider Demographics
NPI:1710635875
Name:TERRY, LINDA S (LPC, LAMFT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:TERRY
Suffix:
Gender:F
Credentials:LPC, LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5693 E HOOTOWL DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83716-7171
Mailing Address - Country:US
Mailing Address - Phone:707-318-7795
Mailing Address - Fax:
Practice Address - Street 1:2500 W KOOTENAI ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-2408
Practice Address - Country:US
Practice Address - Phone:208-908-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-8762101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health