Provider Demographics
NPI:1952962532
Name:TERRY, CURTIS (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:
Last Name:TERRY
Suffix:
Gender:M
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 LUCIA RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-3954
Mailing Address - Country:US
Mailing Address - Phone:412-628-0716
Mailing Address - Fax:
Practice Address - Street 1:1509 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:BRADDOCK
Practice Address - State:PA
Practice Address - Zip Code:15104-2911
Practice Address - Country:US
Practice Address - Phone:412-449-9065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011387101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health