MEDICARE: TERRY T AULTMAN MA LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	61145	TX
2	101YM0800X	Mental Health Counselor	61145	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013121805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRY T AULTMAN MA LPC

Provider Business Mailing Address
First Line	:	6236 N HIGHWAY 146
Second Line	:	SUITE 9
City	:	BAYTOWN
State	:	TX
Zip	:	77523-9081
Country	:	US
Telephone Number	:	281-918-0152
Fax Number	:	281-918-0151

Provider Business Practice Location Address
First Line	:	6236 N HIGHWAY 146
Second Line	:	SUITE 9
City	:	BAYTOWN
State	:	TX
Zip	:	77523-9081
Country	:	US
Telephone Number	:	281-918-0152
Fax Number	:	281-918-0151

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	04/23/2025

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Directions to “ TERRY T AULTMAN MA LPC” Practice Location

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