Provider Demographics
NPI:1427127703
Name:SCHROCK, TERRY L (MS, LMHC)
Entity type:Individual
Prefix:MR
First Name:TERRY
Middle Name:L
Last Name:SCHROCK
Suffix:
Gender:M
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 BROOKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LOGANSPORT
Mailing Address - State:IN
Mailing Address - Zip Code:46947-1205
Mailing Address - Country:US
Mailing Address - Phone:765-456-5900
Mailing Address - Fax:
Practice Address - Street 1:1907 W SYCAMORE ST
Practice Address - Street 2:ST. JOSEPH HOSPITAL & HEALTH CENTER
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46904-9010
Practice Address - Country:US
Practice Address - Phone:765-456-5900
Practice Address - Fax:765-456-5815
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000391215OtherANTHEM BXBS ID NUMBER
IN11548735OtherCAQH ID NUMBER
INSCHRO-0006OtherCOMPCARE ID NUMBER