Provider Demographics
NPI:1255354320
Name:HUFF, TERRY MILTON (LCSW)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:MILTON
Last Name:HUFF
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 MARYLAND WAY
Mailing Address - Street 2:STE 101
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7512
Mailing Address - Country:US
Mailing Address - Phone:615-627-4191
Mailing Address - Fax:615-933-5102
Practice Address - Street 1:5115 MARYLAND WAY
Practice Address - Street 2:STE 101
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7512
Practice Address - Country:US
Practice Address - Phone:615-627-4191
Practice Address - Fax:615-933-5102
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW07721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2007657OtherBCBST
TN3691988Medicare ID - Type Unspecified