Provider Demographics
NPI:1952592271
Name:PHILLIPS, TERRY S, (LMHC)
Entity type:Individual
Prefix:MS
First Name:TERRY
Middle Name:S,
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NH
Mailing Address - Zip Code:03049-6026
Mailing Address - Country:US
Mailing Address - Phone:603-599-5284
Mailing Address - Fax:
Practice Address - Street 1:22 MAIN ST
Practice Address - Street 2:SUITE K
Practice Address - City:HOLLIS
Practice Address - State:NH
Practice Address - Zip Code:03049
Practice Address - Country:US
Practice Address - Phone:603-599-5284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH325101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health