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NPI Code Detail

MEDICARE: TERRI L EASON LPC

MEDICARE: TERRI L EASON LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1861041394
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRI L EASON LPC
Provider Business Mailing Address
First Line : 1935 DOMINION WAY
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-1464
Country : US
Telephone Number : 719-423-7428
Fax Number :
Provider Business Practice Location Address
First Line : 1935 DOMINION WAY
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-1464
Country : US
Telephone Number : 719-423-7428
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2019
Last Update Date : 10/06/2022

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Directions to “ TERRI L EASON LPC” Practice Location

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