Provider Demographics
NPI:1316825185
Name:FEATHERS, TERRANCE
Entity type:Individual
Prefix:
First Name:TERRANCE
Middle Name:
Last Name:FEATHERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11400 158TH ROAD, PO BOX 174
Mailing Address - Street 2:
Mailing Address - City:MAYETTA
Mailing Address - State:KS
Mailing Address - Zip Code:66509-8866
Mailing Address - Country:US
Mailing Address - Phone:785-966-8322
Mailing Address - Fax:
Practice Address - Street 1:11400 158TH RD
Practice Address - Street 2:
Practice Address - City:MAYETTA
Practice Address - State:KS
Practice Address - Zip Code:66509-8866
Practice Address - Country:US
Practice Address - Phone:785-966-8322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01010101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)