Active NPI
Tera Dee Nance, MS, NCC, LMHC
- Mental Health Counselor
- Bloomington, IN
National Provider Identifier
1497079982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39002092A
- Practice address
- 101 W. Kirkwood Avenue
Suite 009 Fountain Square Mall
Bloomington, IN 47404 - Phone
- (812) 272-0934
- Fax
- (812) 339-2799
- NPI assigned
- Mar 26, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39002092A | IN | Primary |
Addresses
Primary practice location
101 W. Kirkwood Avenue
Suite 009 Fountain Square Mall
Bloomington, IN 47404
Mailing address
101 W. Kirkwood Avenue
Suite 009 Fountain Square Mall
Bloomington, IN 47404
Phone (812) 272-0934
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39002092A | IN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285718400000",
"number": "1497079982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 W. KIRKWOOD AVENUE",
"address_2": "SUITE 009 FOUNTAIN SQUARE MALL",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "47404",
"telephone_number": "812-272-0934",
"fax_number": "812-339-2799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W. KIRKWOOD AVENUE",
"address_2": "SUITE 009 FOUNTAIN SQUARE MALL",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "47404",
"telephone_number": "812-272-0934",
"fax_number": "812-339-2799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NANCE",
"first_name": "TERA",
"middle_name": "DEE",
"credential": "MS, NCC, LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-26",
"last_updated": "2010-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39002092A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.