Provider Demographics
NPI:1760047062
Name:STURGES, TERRI (LMSW)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:STURGES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 1ST ST NW
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-3507
Mailing Address - Country:US
Mailing Address - Phone:712-522-1119
Mailing Address - Fax:712-587-9695
Practice Address - Street 1:125 1ST ST NW
Practice Address - Street 2:
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-3507
Practice Address - Country:US
Practice Address - Phone:712-522-1119
Practice Address - Fax:712-587-9695
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007170101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA007170OtherLMSW LICENSE