Provider Demographics
NPI:1063764827
Name:NAUGHTON, TERRI ANN (LCSW, LISW-S, LAC)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:ANN
Last Name:NAUGHTON
Suffix:
Gender:F
Credentials:LCSW, LISW-S, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 AIRLIFT WING / SGOH, DIR OF PSYCH HEALTH
Mailing Address - Street 2:3976 KING GRAVES ROAD, UNIT 03
Mailing Address - City:VIENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44473-5903
Mailing Address - Country:US
Mailing Address - Phone:330-609-1500
Mailing Address - Fax:330-609-1449
Practice Address - Street 1:3976 KING GRAVES RD
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:OH
Practice Address - Zip Code:44473-5903
Practice Address - Country:US
Practice Address - Phone:330-609-1500
Practice Address - Fax:330-609-1449
Is Sole Proprietor?:No
Enumeration Date:2012-10-03
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001699101YA0400X
COACC.0020781101YA0400X
CO21401041C0700X
OHI.17000211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)