Healthcare Provider Details

I. General information

NPI: 1972126480
Provider Name (Legal Business Name): TERRILYN BATTLE LCMHC-A, LCAS-A, CRC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TERRILYN BATTLE LCMHC-A, LCAS-A, CRC

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 07/25/2022
Certification Date: 07/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 PARKWAY ST STE I
GREENSBORO NC
27401-1644
US

IV. Provider business mailing address

411 PARKWAY ST STE I
GREENSBORO NC
27401-1644
US

V. Phone/Fax

Practice location:
  • Phone: 336-301-9247
  • Fax: 855-899-6137
Mailing address:
  • Phone: 336-301-9247
  • Fax: 855-899-6137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCRC-00116794
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: