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General NPI Number Information
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NPI Number | 1063764827
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Entity Type | Individual
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Provider Name | TERRI ANN NAUGHTON LCSW, LISW-S, LAC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2012
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Last Update Date | 04/12/2021
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Provider Practice Location Address
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Address Line | 3976 KING GRAVES RD
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City | VIENNA
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State | OH
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Zip | 44473-5903
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Country | US
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Telephone | 330-609-1500
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Fax | 330-609-1449
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Provider Business Mailing Address
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Address Line | 910 AIRLIFT WING / SGOH, DIR OF PSYCH HEALTH 3976 KING GRAVES ROAD, UNIT 03
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City | VIENNA
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State | OH
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Zip | 44473-5903
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Country | US
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Telephone | 330-609-1500
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Fax | 330-609-1449
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACD.0001699
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACC.0020781
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2140
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.1700021
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License Number State | OH
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