Provider Demographics
NPI:1366901803
Name:PILKERTON, TERRI (MAED, NCC)
Entity type:Individual
Prefix:MS
First Name:TERRI
Middle Name:
Last Name:PILKERTON
Suffix:
Gender:F
Credentials:MAED, NCC
Other - Prefix:MS
Other - First Name:THERESA
Other - Middle Name:ANN
Other - Last Name:PILKERTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1360 BEVERLY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3647
Mailing Address - Country:US
Mailing Address - Phone:703-831-8300
Mailing Address - Fax:
Practice Address - Street 1:1360 BEVERLY RD STE 200
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3647
Practice Address - Country:US
Practice Address - Phone:703-831-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-14
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty