Reginald Charles Terry, MA, LLPC, CAADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401011111 Issued in MI

Practice address

35031 23 Mile Rd
New Baltimore, MI 48047-3649

Phone

(586) 725-5777

Fax

(586) 725-4099

NPI assigned

Jun 24, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Diversus Health IncGroup PAC ID 7719879204, 49 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Diversus Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colorado Springs, CO
  • NPI 1043260243
  Medicare reassignment Care Compare group NPD
• Central Care Management Organization

  • Prevention Professional
  • Detroit, MI
  • NPI 1790373579
  NPD Authorized official
• Diversus Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colorado Springs, CO
  • NPI 1295269561
  NPD
• Diversus Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colorado Springs, CO
  • NPI 1457716128
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1023279841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35031 23 MILE RD",
            "city": "NEW BALTIMORE",
            "state": "MI",
            "postal_code": "480473649",
            "telephone_number": "586-725-5777",
            "fax_number": "586-725-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35031 23 MILE RD",
            "city": "NEW BALTIMORE",
            "state": "MI",
            "postal_code": "480473649",
            "telephone_number": "586-725-5777",
            "fax_number": "586-725-4099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6071 E Woodmen Rd Ste 135",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809232608",
            "country_code": "US",
            "telephone_number": "719-572-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TERRY",
        "first_name": "REGINALD",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "MA, LLPC, CAADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0018882",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401011111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Shoaf, RN
• Krystal Tamara Simpson, LPN
• William D. Smyka, M.D.
• Ashley Jessica Stanciu, LLMSW
• Storybrook Counseling Center PLLC
• Aaron Curtis Teutsch, MA, LLPC
• Jennifer Lee Theodore, LMSW
• Akosua Naomi Thornton, LLPC
• Porsche Ufot
• Kim Urkshus, LMT

• Professional Counselor in New Baltimore, MI
• Providers in New Baltimore, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.