Provider Demographics
NPI:1265684930
Name:WOOD, TERI L (MA, LMHC)
Entity type:Individual
Prefix:
First Name:TERI
Middle Name:L
Last Name:WOOD
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11410 NE 124TH ST # 459
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-4305
Mailing Address - Country:US
Mailing Address - Phone:206-755-0672
Mailing Address - Fax:
Practice Address - Street 1:12040 98TH AVE NE # 204B
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4290
Practice Address - Country:US
Practice Address - Phone:206-755-0672
Practice Address - Fax:206-589-1995
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60463861101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health