Terri Martin Revelle, MA, LPA is a
Psychologist based in Jackson, North Carolina. Terri Martin Revelle is licensed to practice in North Carolina (license number 3749) and her current practice location is
111 E. Jefferson St., Jackson, North Carolina. She can be reached at her office (for appointments etc.) via phone at
(252) 578-3918.
NPI number for Terri Martin Revelle is 1013109552 and her current mailing address is 518 Pine Tops Rd, Murfreesboro, North Carolina. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1013109552.
Healthcare Provider's Profile
| Full Name | Terri Martin Revelle |
|---|
| Gender | Female |
|---|
| Speciality | Psychologist |
|---|
| Location | 111 E. Jefferson St., Jackson, North Carolina |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1013109552
- Provider Enumeration Date: 08/17/2007
- Last Update Date: 01/16/2015
Medical Identifiers
Medical identifiers for Terri Martin Revelle such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013109552 | NPI | - | NPPES |
| 157CH | Other | NC | BLUE CROSS BLUE SHIELD |
| 6107657 | Medicaid | NC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | 3749 (North Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Terri Martin Revelle is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Terri Martin Revelle, MA, LPA
518 Pine Tops Rd,
Murfreesboro, NC 27855-9663
Ph: (252) 578-3918 | Terri Martin Revelle, MA, LPA
111 E. Jefferson St.,
Jackson, NC 27845
Ph: (252) 578-3918 |
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