Healthcare Provider Details

I. General information

NPI: 1285399238
Provider Name (Legal Business Name): TERRA NOIROT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERRA CAMPBELL LLMSW

II. Dates (important events)

Enumeration Date: 11/04/2021
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 N FRANKLIN ST
MOUNT PLEASANT MI
48858-2303
US

IV. Provider business mailing address

207 N FRANKLIN ST
MOUNT PLEASANT MI
48858-2303
US

V. Phone/Fax

Practice location:
  • Phone: 989-824-2374
  • Fax: 989-546-8550
Mailing address:
  • Phone: 989-824-2374
  • Fax: 989-546-8550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1285399238
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: