MEDICARE: TERRICA L PUGH

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1659266963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRICA L PUGH

Provider Business Mailing Address
First Line	:	3420 BEXVIE AVE STE D
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43227-3790
Country	:	US
Telephone Number	:	614-824-3827
Fax Number	:	614-824-3827

Provider Business Practice Location Address
First Line	:	3420 BEXVIE AVE STE D
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43227-3790
Country	:	US
Telephone Number	:	614-824-3827
Fax Number	:	614-824-3827

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

Provider Enumeration Date	:	06/09/2025
Last Update Date	:	06/09/2025

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Directions to “ TERRICA L PUGH ” Practice Location

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