Provider Demographics
NPI:1841231503
Name:MCDANIEL, TERRELL M (PHD)
Entity Type:Individual
Prefix:
First Name:TERRELL
Middle Name:M
Last Name:MCDANIEL
Suffix:
Gender:M
Credentials:PHD
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 1155
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37077-1155
Mailing Address - Country:US
Mailing Address - Phone:615-822-3041
Mailing Address - Fax:615-822-8306
Practice Address - Street 1:131 SANDERS FERRY RD STE 302
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3662
Practice Address - Country:US
Practice Address - Phone:615-822-1222
Practice Address - Fax:615-822-8306
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP1191103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical