Active NPI
Teddy Terhune
- Professional Counselor
- Austin, TX
National Provider Identifier
1255712139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 69615
- Practice address
- 5304A Woodrow Ave
Austin, TX 78756-2107 - Phone
- (512) 586-8118
- Fax
- (512) 672-6166
- NPI assigned
- Jun 16, 2015
- Last updated
- Sep 22, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 69615 | TX | Primary |
| Mental Health Counselor | 101YM0800X | 69615 | TX |
Addresses
Primary practice location
5304A Woodrow Ave
Austin, TX 78756-2107
Mailing address
5304A Woodrow Ave
Austin, TX 78756-2107
Phone (512) 586-8118
Other practice location 1
1015 Beecave Woods Dr
Suite 300F
Austin, TX 78746-6762
Phone (512) 586-8118
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0004FR | Other | BLUECROSS BLUESHIELD OF TEXAS |
Other names 1
- Teddy Terhune
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69615 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537574400000",
"number": "1255712139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5304A WOODROW AVE",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787562107",
"telephone_number": "512-586-8118",
"fax_number": "512-672-6166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5304A WOODROW AVE",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787562107",
"telephone_number": "512-586-8118",
"fax_number": "512-672-6166"
}
],
"practiceLocations": [
{
"address_1": "1015 Beecave Woods Dr",
"address_2": "Suite 300F",
"address_purpose": "LOCATION",
"city": "Austin",
"state": "TX",
"postal_code": "787466762",
"country_code": "US",
"telephone_number": "512-586-8118",
"fax_number": "512-672-6166",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TERHUNE",
"first_name": "TEDDY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-16",
"last_updated": "2018-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "69615",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "69615",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD OF TEXAS",
"identifier": "0004FR",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TEDDY",
"last_name": "TERHUNE",
"credential": "JD, MA",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.