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General NPI Number Information
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NPI Number | 1548660541
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Entity Type | Individual
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Provider Name | STACY TERRELL LPC
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Gender | Female
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Dates
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Enumeration Date | 08/26/2014
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Last Update Date | 08/26/2014
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Provider Practice Location Address
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Address Line | 8008 SLIDE RD STE 24
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City | LUBBOCK
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State | TX
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Zip | 79424-2828
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Country | US
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Telephone | 817-437-6900
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Fax | 806-698-8378
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Provider Business Mailing Address
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Address Line | 8008 SLIDE RD STE 24
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City | LUBBOCK
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State | TX
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Zip | 79424-2828
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Country | US
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Telephone | 817-437-6900
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Fax | 806-698-8378
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 64111
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License Number State | TX
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