Provider Demographics
NPI:1851091425
Name:TERRY, MARCIA (LCSWA)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:TERRY
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:MARCIA
Other - Middle Name:
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 GRAVELY DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-3310
Mailing Address - Country:US
Mailing Address - Phone:919-538-4837
Mailing Address - Fax:
Practice Address - Street 1:200 GRAVELY DR
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-3310
Practice Address - Country:US
Practice Address - Phone:919-538-4837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0186831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical