Provider Demographics
NPI:1861522989
Name:PINSON, TERRI (LCSW)
Entity type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:
Last Name:PINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:TERRI
Other - Middle Name:
Other - Last Name:PINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 405
Mailing Address - Street 2:
Mailing Address - City:PURVIS
Mailing Address - State:MS
Mailing Address - Zip Code:39475-0405
Mailing Address - Country:US
Mailing Address - Phone:601-466-7156
Mailing Address - Fax:601-558-2226
Practice Address - Street 1:1442 16TH STREET
Practice Address - Street 2:MEDICAL TASK FORCE SHELBY
Practice Address - City:CAMP SHELBY
Practice Address - State:MS
Practice Address - Zip Code:39407
Practice Address - Country:US
Practice Address - Phone:601-558-4772
Practice Address - Fax:601-558-2226
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC7138104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS18212Medicaid