Provider Demographics
NPI:1699956078
Name:AUBIN, TERRI LYNN (LICSW)
Entity type:Individual
Prefix:MS
First Name:TERRI
Middle Name:LYNN
Last Name:AUBIN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:TERRI
Other - Middle Name:LYNN
Other - Last Name:SIEGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:28 ORIOLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110
Mailing Address - Country:US
Mailing Address - Phone:978-551-6907
Mailing Address - Fax:207-438-1062
Practice Address - Street 1:402 GOODRICH AVENUE
Practice Address - Street 2:
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904
Practice Address - Country:US
Practice Address - Phone:207-438-5722
Practice Address - Fax:207-438-1062
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW140011041C0700X
NH10011041C0700X
MA1104161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH140012047OtherBHN
NH2223248OtherCIGNA
NH30423550Medicaid
NH470331OtherTUFTS
NH79716700OtherMAGELLAN
NH79716700OtherMAGELLAN