Provider Demographics
NPI:1922282185
Name:FIELDS, TERRY RUTH (LPA)
Entity Type:Individual
Prefix:MS
First Name:TERRY
Middle Name:RUTH
Last Name:FIELDS
Suffix:
Gender:F
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3570
Mailing Address - Country:US
Mailing Address - Phone:541-556-9179
Mailing Address - Fax:541-556-9179
Practice Address - Street 1:125 E 8TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2926
Practice Address - Country:US
Practice Address - Phone:541-682-4560
Practice Address - Fax:541-556-9179
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5025101Y00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor