Provider Demographics
NPI:1982853891
Name:STANCLIFT, TERRY L (LPC)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:L
Last Name:STANCLIFT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 ALBANY AVE
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:WY
Mailing Address - Zip Code:82240-1503
Mailing Address - Country:US
Mailing Address - Phone:307-532-4091
Mailing Address - Fax:307-532-8409
Practice Address - Street 1:501 ALBANY AVE
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:WY
Practice Address - Zip Code:82240-1503
Practice Address - Country:US
Practice Address - Phone:307-532-4091
Practice Address - Fax:307-532-8409
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY983101YP2500X
WYLPC-983101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY261QM0801XMedicaid
WY261QR0405XMedicaid
WY315451OtherBLUE CROSS BLUE SHIELD OF WY