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General NPI Number Information
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NPI Number | 1992119226
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Entity Type | Individual
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Provider Name | TERRY D. GARTRELL M.A., RMHCI
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Gender | Female
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Dates
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Enumeration Date | 06/14/2014
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Last Update Date | 07/14/2018
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Provider Practice Location Address
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Address Line | 5739 ABELIA RD
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City | JACKSONVILLE
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State | FL
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Zip | 32209
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Country | US
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Telephone | 904-859-3799
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 KINGS RD UNIT 43402
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City | JACKSONVILLE
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State | FL
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Zip | 32203-9500
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Country | US
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Telephone | 904-310-8222
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH11338
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License Number State | FL
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