Provider Demographics
NPI:1952658510
Name:TERRY, DANIELLE J (LMHC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:J
Last Name:TERRY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9165 OTIS AVE STE 242
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46216-2317
Mailing Address - Country:US
Mailing Address - Phone:317-626-5424
Mailing Address - Fax:
Practice Address - Street 1:9165 OTIS AVE STE 242
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46216-2317
Practice Address - Country:US
Practice Address - Phone:317-626-5424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002161A101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health