| Debra L. Terry Lcsw, P.c. | |
|
4 Phyllis Dr Ste G Patchogue NY 11772-2900 | |
| (631) 882-2940 | |
| (631) 923-1579 |
| Full Name | Debra L. Terry Lcsw, P.c. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4 Phyllis Dr Ste G, Patchogue, New York |
| Authorized Official Name and Position | Debra L Terry (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6318822940 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Debra L. Terry Lcsw, P.c. 21 Pine Tree Rd Huntington Station NY 11746-7428 Ph: (631) 882-2940 | Debra L. Terry Lcsw, P.c. 4 Phyllis Dr Ste G Patchogue NY 11772-2900 Ph: (631) 882-2940 |
| NPI Number | 1831701630 |
|---|---|
| Provider Enumeration Date | 08/21/2020 |
| Last Update Date | 08/21/2020 |
| Certification Date | 08/21/2020 |
| Medicare PECOS PAC ID | 6103245931 |
|---|---|
| Medicare Enrollment ID | O20200929001074 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831701630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Debra L Terry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073717765 PECOS PAC ID: 0547354144 Enrollment ID: I20070913000093 |
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