Deronda Vynette Terry, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

6005 Park Ave Ste 630B
Memphis, TN 38119-5226

Phone

(901) 767-1136

NPI assigned

Oct 5, 2006

Last updated

Sep 19, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Mrs. Deronda Vynette King Former name

Medicare fee-for-service enrollment

Enrolled in TN

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Step Up Care of Tennessee LLCGroup PAC ID 5395074728, 35 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Step Up Care of Tennessee LLC

  • Psychologist
  • Memphis, TN
  • NPI 1023660206
  Medicare reassignment Care Compare group
• Case Management Inc

  • Case Management Agency
  • Memphis, TN
  • NPI 1326116476
  Medicare reassignment NPD
• Your Community Health & Wellness

  • Multi-Specialty Clinic/Center
  • Memphis, TN
  • NPI 1154793727
  NPD

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1639265085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE STE 630B",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195226",
            "telephone_number": "901-767-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE STE 630B",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195226",
            "telephone_number": "901-767-1136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3810 Winchester Rd",
            "address_2": "Southeast Mental Health Center",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381189007",
            "country_code": "US",
            "telephone_number": "901-369-1420",
            "fax_number": "901-369-1433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TERRY",
        "first_name": "DERONDA",
        "middle_name": "VYNETTE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DERONDA",
            "last_name": "KING",
            "middle_name": "VYNETTE",
            "prefix": "MRS.",
            "credential": "MAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Terrell
• William Terrell Jr., M.D.
• Robin Terry-Purnell, PHARM.D.
• Angela Terry
• Dava Mackensie Terry
• Dominique Latasha Terry, RDH
• Joan Burgart Terry, LCSW
• Leanne Terry, NP
• Meghann Terry, R.D., L.D.N.
• Timothy Terry

• Professional Counselor in Memphis, TN
• Providers in Memphis, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.