Individual provider Active NPI

Molly Jean Terry, LMHC

  • Mental Health Counselor
  • Palm Harbor, FL
National Provider Identifier
1265426902
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH17850 Issued in FL
Practice address
3023 US-19 Alt
Suite 102
Palm Harbor, FL 34683
Phone
(727) 254-9183
NPI assigned
Sep 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH17850 FL Primary

Addresses

Primary practice location

3023 US-19 Alt
Suite 102
Palm Harbor, FL 34683

Mailing address

3023 US-19 Alt
Suite 102
Palm Harbor, FL 34683
Phone (727) 254-9183

Other practice location 1

1975 W Main St
Owosso, MI 48867-9317
Phone (989) 723-0791

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

LicenseStateTypeSpecialty
MH17850FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Harbor Counseling Team CurrentSince Mar 1, 2020 Accepting new patients
Shiawassee County Community Mental Health Authority Past Accepting new patients

Locations

3023 Alt 19
Ste 102
Palm Harbor, FL 34683
Phone (727) 220-2203

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1265426902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 US-19 ALT",
            "address_2": "SUITE 102",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "34683",
            "telephone_number": "727-254-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 US-19 ALT",
            "address_2": "SUITE 102",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "34683",
            "telephone_number": "727-254-9183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1975 W Main St",
            "address_purpose": "LOCATION",
            "city": "Owosso",
            "state": "MI",
            "postal_code": "488679317",
            "country_code": "US",
            "telephone_number": "989-723-0791",
            "fax_number": "989-725-5061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TERRY",
        "first_name": "MOLLY",
        "middle_name": "JEAN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH17850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.