Provider Demographics
NPI:1750476305
Name:MORAN, TERRI SUE (MS, LIMHP, CPC)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:SUE
Last Name:MORAN
Suffix:
Gender:F
Credentials:MS, LIMHP, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2583
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848-2583
Mailing Address - Country:US
Mailing Address - Phone:308-234-6029
Mailing Address - Fax:308-237-4792
Practice Address - Street 1:3814 A AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-8124
Practice Address - Country:US
Practice Address - Phone:308-234-6029
Practice Address - Fax:308-237-4792
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1310101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025789800Medicaid
NE732316000OtherMAGELLAN BEHAVIORAL HEALT
NE82359OtherBLUE CROSS BLUE SHIELD