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NPI 1386512325

NPI 1386512325 : TERI VERMILION LCAC-A : KOKOMO, IN

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General NPI Number Information
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    NPI Number           |    1386512325
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    Entity Type          |    Individual 
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    Provider Name        |    TERI VERMILION LCAC-A
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/29/2025
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    Last Update Date     |    10/29/2025
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Provider Practice Location Address
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    Address Line         |    1234 N COURTLAND AVE 
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    City                 |    KOKOMO
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    State                |    IN
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    Zip                  |    46901-2754
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    Country              |    US
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    Telephone            |    765-860-7482
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3775 E STATE ROAD 218 
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    City                 |    PERU
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    State                |    IN
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    Zip                  |    46970-7857
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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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       |    87900187A
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    License Number State |    IN
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