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NPI Code Detail

MEDICARE: TERI VERMILION LCAC-A

MEDICARE: TERI VERMILION LCAC-A
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
1101YA0400XAddiction (Substance Use Disorder) Counselor87900187AIN

General Provider Information

NPI Number : 1386512325
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERI VERMILION LCAC-A
Provider Business Mailing Address
First Line : 3775 E STATE ROAD 218
Second Line :
City : PERU
State : IN
Zip : 46970-7857
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1234 N COURTLAND AVE
Second Line :
City : KOKOMO
State : IN
Zip : 46901-2754
Country : US
Telephone Number : 765-860-7482
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2025
Last Update Date : 10/29/2025

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Directions to “ TERI VERMILION LCAC-A” Practice Location

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