Provider Demographics
NPI:1184815920
Name:TERRY, KAREN R (CACII)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:R
Last Name:TERRY
Suffix:
Gender:F
Credentials:CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:950 DANNON VIEW
Mailing Address - Street 2:SUITE #4201
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331
Mailing Address - Country:US
Mailing Address - Phone:404-629-6117
Mailing Address - Fax:404-346-6147
Practice Address - Street 1:950 DANNON VIEW
Practice Address - Street 2:SUITE #4201
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331
Practice Address - Country:US
Practice Address - Phone:404-629-6117
Practice Address - Fax:404-346-6147
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA013623101YA0400X
GA1690101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)