Provider Demographics
NPI:1538359021
Name:TERA L. STORMS, PSY.D., P.C.
Entity type:Organization
Organization Name:TERA L. STORMS, PSY.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TERA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:STORMS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:585-301-7483
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:NY
Mailing Address - Zip Code:14454-0306
Mailing Address - Country:US
Mailing Address - Phone:585-301-7483
Mailing Address - Fax:585-359-8055
Practice Address - Street 1:150 COURT ST
Practice Address - Street 2:SUITE 1
Practice Address - City:GENESEO
Practice Address - State:NY
Practice Address - Zip Code:14454-1036
Practice Address - Country:US
Practice Address - Phone:585-301-7483
Practice Address - Fax:585-359-8055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016169251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02638379Medicaid
NYQ43318Medicare UPIN