Provider Demographics
NPI:1801376512
Name:PATTILLO, TERRI MICHELLE (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:MICHELLE
Last Name:PATTILLO
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5457 HAYS ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-2077
Mailing Address - Country:US
Mailing Address - Phone:412-758-0034
Mailing Address - Fax:412-212-0781
Practice Address - Street 1:311 S CRAIG ST # M4
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3734
Practice Address - Country:US
Practice Address - Phone:412-727-8264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010574101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional