Terry Abbott
Individual provider Active NPI Clinical Social Worker · Fort Walton Beach, FL
NPI 1013392810 · NPPES record last updated Aug 11, 2018
Key facts
- NPI
- 1013392810
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- SW15100 (FL)
- Practice address
- 648 Overbrook Dr
Fort Walton Beach, FL 32547 - Phone
- (850) 736-5211
- NPI assigned
- Jul 22, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW15100 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shades of Color Counseling Services LLC | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW15100 | FL | Yes |
Addresses
Primary practice location
648 Overbrook Dr
Fort Walton Beach, FL 32547
Mailing address
648 Overbrook Dr
Fort Walton Beach, FL 32547-3548
Phone (850) 736-5211
Other providers in Fort Walton Beach, FL
- 96TH MDG Eglin Afb
- Aaron B Stein MD PLLC
- ABA Behavioral Health
- ABA Lyfe, PLLC
- Cassidy Abbott Catron
- Katie Able
- Kelly Amanda Abrams
- Christopher Dale Abrasley
- Ashley Accardi
- Julie Accorti
All providers in Fort Walton Beach, FL · Clinical Social Worker in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.