Provider Demographics
NPI:1902995046
Name:TERRY, DARLENE HOLLAND (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:HOLLAND
Last Name:TERRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 BEVERLY HTS
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-2911
Mailing Address - Country:US
Mailing Address - Phone:205-242-6919
Mailing Address - Fax:205-737-7615
Practice Address - Street 1:13 BEVERLY HTS
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-2911
Practice Address - Country:US
Practice Address - Phone:205-242-6919
Practice Address - Fax:205-737-7615
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL05101188C1041C0700X
NMI-075701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051551126Medicare UPIN
AL051551126TERMedicare UPIN