Provider Demographics
NPI:1215105184
Name:TERRILLION, MICHAEL (LCSW, LPC, CEAP, MHA)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:TERRILLION
Suffix:
Gender:M
Credentials:LCSW, LPC, CEAP, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28071 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LACOMBE
Mailing Address - State:LA
Mailing Address - Zip Code:70445-6433
Mailing Address - Country:US
Mailing Address - Phone:985-264-2625
Mailing Address - Fax:985-882-6014
Practice Address - Street 1:28071 MAIN STREET
Practice Address - Street 2:
Practice Address - City:LACOMBE
Practice Address - State:LA
Practice Address - Zip Code:70445-0943
Practice Address - Country:US
Practice Address - Phone:985-264-2625
Practice Address - Fax:985-882-6014
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA80621041C0700X
LA3058101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional