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NPI Code Detail

MEDICARE: TERRELL IVY LPC, CPSSP

MEDICARE: TERRELL IVY LPC, CPSSP
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
1101YP2500XProfessional Counselor100551TX
2175T00000XPeer Specialist468MS
3101YP2500XProfessional Counselor3329MS

General Provider Information

NPI Number : 1326912569
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRELL IVY LPC, CPSSP
Provider Business Mailing Address
First Line : 7200 WYOMING SPRINGS DR STE 1600
Second Line :
City : ROUND ROCK
State : TX
Zip : 78681-4307
Country : US
Telephone Number : 512-253-4768
Fax Number :
Provider Business Practice Location Address
First Line : 7200 WYOMING SPRINGS DR STE 1600
Second Line :
City : ROUND ROCK
State : TX
Zip : 78681-4307
Country : US
Telephone Number : 512-253-4768
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2025
Last Update Date : 01/13/2026

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Directions to “ TERRELL IVY LPC, CPSSP” Practice Location

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