Provider Demographics
NPI:1720781578
Name:TERWILLIGER, WINDY (LCAS, LCSWA)
Entity Type:Individual
Prefix:
First Name:WINDY
Middle Name:
Last Name:TERWILLIGER
Suffix:
Gender:F
Credentials:LCAS, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 MATTEO DR APT 203
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2116
Mailing Address - Country:US
Mailing Address - Phone:910-352-6533
Mailing Address - Fax:
Practice Address - Street 1:1920 S 16TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6611
Practice Address - Country:US
Practice Address - Phone:910-632-2191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28826101YA0400X
NCP0187661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)