Provider Demographics
NPI:1366318339
Name:WOODSON, TERRANCE STEPHEN
Entity type:Individual
Prefix:
First Name:TERRANCE
Middle Name:STEPHEN
Last Name:WOODSON
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 1:1944 E HEBRON PKWY
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-1525
Mailing Address - Country:US
Mailing Address - Phone:972-492-4300
Mailing Address - Fax:
Practice Address - Street 1:1944 E HEBRON PKWY
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-1525
Practice Address - Country:US
Practice Address - Phone:972-492-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77660101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional