Provider Demographics
NPI:1093133605
Name:WOOLARD, TERI PINER (MA, LPCA, NCC)
Entity type:Individual
Prefix:
First Name:TERI
Middle Name:PINER
Last Name:WOOLARD
Suffix:
Gender:F
Credentials:MA, LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 GOLDIE ST
Mailing Address - Street 2:
Mailing Address - City:KILL DEVIL HILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27948-7519
Mailing Address - Country:US
Mailing Address - Phone:252-564-4964
Mailing Address - Fax:
Practice Address - Street 1:1311 GOLDIE ST
Practice Address - Street 2:
Practice Address - City:KILL DEVIL HILLS
Practice Address - State:NC
Practice Address - Zip Code:27948-7519
Practice Address - Country:US
Practice Address - Phone:252-564-4964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10763101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health