Provider Demographics
NPI:1427614536
Name:TERRY, KATIE MARIE (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:MARIE
Last Name:TERRY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12875 WILLOW BAY DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73165-3201
Mailing Address - Country:US
Mailing Address - Phone:405-979-0276
Mailing Address - Fax:
Practice Address - Street 1:127 CECIL LN # 127
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-2211
Practice Address - Country:US
Practice Address - Phone:405-979-0276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-14
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10857101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health