Terry Lee Shultz, M.ED.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC013978 Issued in PA

Practice address

2023 Cato Ave
State College, PA 16801-2765

Phone

(814) 308-8375

Fax

(814) 308-8126

NPI assigned

Dec 1, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Terry Lee Shultz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

Practice roles

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.

• Healing Room Inc.

  • Clinical Social Worker
  • State College, PA
  • NPI 1033501523

  Professional

  NPD (past)

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1700544335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 DOUGLAS DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168031536",
            "telephone_number": "814-441-4508",
            "fax_number": "814-308-8126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 CATO AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168012765",
            "telephone_number": "814-308-8375",
            "fax_number": "814-308-8126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULTZ",
        "first_name": "TERRY",
        "middle_name": "LEE",
        "credential": "M.ED.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC013978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRY",
            "last_name": "SHULTZ",
            "middle_name": "LEE",
            "prefix": "MR.",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Lee Shingledecker, OTR/L
• Brian W Shippert, D.O.
• Michelle Nicole Stalter Shippert, DO
• Stephen Shoup
• Joanne C Shultz, CRNP
• Jessica Buczek Shuman, M.D.
• Brian Raymond Shunk, DO
• Stephen Dallery Shurgalla, PA-C
• Dimitri Gregory Sidorick, DPT
• Summer Anne Sikes, PHARM D

• Professional Counselor in State College, PA
• Providers in State College, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.