Provider Demographics
NPI:1063746253
Name:GERLACH, TERRI T (PHD, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:TERRI
Middle Name:T
Last Name:GERLACH
Suffix:
Gender:
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6035 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3256
Mailing Address - Country:US
Mailing Address - Phone:704-295-3000
Mailing Address - Fax:704-838-8494
Practice Address - Street 1:6035 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3256
Practice Address - Country:US
Practice Address - Phone:704-295-3000
Practice Address - Fax:704-838-8494
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8236235Z00000X
NC2086235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7413361Medicaid
SC770344OtherWELLCARE
30109418OtherSELECT HEALTH
SCSAN086Medicaid
NC16262OtherBCBSNC
NCP01044531OtherRAILROAD MEDICARE PTAN
NCP01044531OtherRAILROAD MEDICARE PTAN