Provider Demographics
NPI:1154392165
Name:LOVE, TERRY LYNN (LPC)
Entity type:Individual
Prefix:MRS
First Name:TERRY
Middle Name:LYNN
Last Name:LOVE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 LOYOLA DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-5222
Mailing Address - Country:US
Mailing Address - Phone:810-239-6566
Mailing Address - Fax:810-762-9929
Practice Address - Street 1:718 LOYOLA DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-5222
Practice Address - Country:US
Practice Address - Phone:810-239-6566
Practice Address - Fax:810-762-9929
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401004391101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health