Provider Demographics
NPI:1285804179
Name:LAYNE, TERRENCE A
Entity type:Individual
Prefix:MR
First Name:TERRENCE
Middle Name:A
Last Name:LAYNE
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:TERRY
Other - Middle Name:
Other - Last Name:LAYNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:6031 COVENTRY FLS
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-6391
Mailing Address - Country:US
Mailing Address - Phone:281-744-9513
Mailing Address - Fax:
Practice Address - Street 1:6031 COVENTRY FLS
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-6391
Practice Address - Country:US
Practice Address - Phone:281-744-9513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10418101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional