Provider Demographics
NPI:1821008277
Name:WOODS, TERRY LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TERRY
Middle Name:LYNN
Last Name:WOODS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1267 NICK A JACK RD
Mailing Address - Street 2:
Mailing Address - City:FLINTSTONE
Mailing Address - State:GA
Mailing Address - Zip Code:30725-2529
Mailing Address - Country:US
Mailing Address - Phone:423-424-4284
Mailing Address - Fax:
Practice Address - Street 1:2236 HAMILL RD
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-4031
Practice Address - Country:US
Practice Address - Phone:423-877-5631
Practice Address - Fax:423-876-0394
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000007541041C0700X
GACSWOO36371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00275157Medicare PIN
TN3987124Medicare ID - Type UnspecifiedFEDERAL MEDICARE NUMBER