Provider Demographics
NPI:1912549775
Name:POND, TERRY (LPC)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:POND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:
Other - Last Name:PYATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1333 84TH PL SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97317-9179
Mailing Address - Country:US
Mailing Address - Phone:503-990-2912
Mailing Address - Fax:
Practice Address - Street 1:3295 TRIANGLE DR SE STE 100
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4566
Practice Address - Country:US
Practice Address - Phone:503-773-6809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-14
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR6034101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health