MS. DERONDA VYNETTE TERRY (NPI# 1639265085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639265085 |
| Entity Type | Individual |
| Full Name | MS. DERONDA VYNETTE TERRY |
| Other Name | MRS. DERONDA VYNETTE KING |
| Credential | LPC |
| Practice Address |
6005 Park Ave Ste 630b Memphis TN 38119-5226 |
| Practice Telephone | 9017671136 |
| Mailing Telephone | 9017671136 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2018-09-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 101YP2500X |
Counselor Specialization: Professional |
TN | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3810 Winchester Rd, Southeast Mental Health Center, Memphis, TN 381189007 | 9013691420 | 9013691433 |
| Street Address |
6005 PARK AVE STE 630B |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38119-5226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902991706 | Kenny Nmi Terry | Psychiatry & Neurology | 6005 Park Ave Ste 630b, Memphis, TN 38119-5226 | 2006-10-04 |
| 1265030175 | Clifton Mcrae Allred | Registered Nurse | 6005 Park Ave Ste 630b, Memphis, TN 38119-5226 | 2020-10-13 |
| 1841787694 | Dennis Lamar Painter I | Psychologist | 6005 Park Ave Ste 630b, Memphis, TN 38119-5226 | 2018-04-17 |
| 1356850283 | Sarah Vogelfanger | Nurse Practitioner | 6005 Park Ave Ste 630b, Memphis, TN 38119-5226 | 2017-09-22 |
| 1174032213 | Michael David Hobbs | Nurse Practitioner | 6005 Park Ave Ste 630b, Memphis, TN 38119-5226 | 2017-09-20 |
| 1043752793 | Camillia Haddix | Registered Nurse | 6005 Park Ave Ste 630b, Memphis, TN 38119-5226 | 2016-11-12 |
| 1679716013 | Nga Huynh | Psychiatry & Neurology | 6005 Park Ave Ste 630b, Memphis, TN 38119-5226 | 2009-04-15 |
| 1952555872 | Rsk Enterprises LLC | Social Worker | 6005 Park Ave Ste 630b, Memphis, TN 38119-5226 | 2008-11-05 |
| 1982855763 | First Pharmacy Services of Park Ave Inc | Durable Medical Equipment & Medical Supplies | 6005 Park Ave Ste 630b, Memphis, TN 38119-5226 | 2008-10-10 |
| 1902966765 | Chante Smith-steward Fason | Nurse Practitioner | 6005 Park Ave Ste 630b, Memphis, TN 38119-5226 | 2006-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417469628 | Jojuan Fullwiley | Behavioral Analyst | 6685 Quince Rd Ste 116, Memphis, TN 38119 | 2017-10-27 |
| 1336675297 | Jill Budynas Depriest | Counselor | 5583 Murray Ave Ste 203, Memphis, TN 38119 | 2017-05-11 |
| 1396279220 | Glen Matthew Stamps Jr. | Counselor | 5583 Murray Ave Ste 207, Memphis, TN 38119 | 2017-04-18 |
| 1598117442 | Hazel Aberdeen | Chiropractor | 1911 Memphis Tennessee, Memphis, TN 38119 | 2016-07-04 |
| 1831569060 | E-c-t Non Emergency Medical Transport | Non-emergency Medical Transport (VAN) | 6869 Woodlake Dr, Memphis, TN 38119 | 2015-09-30 |
| 1053781617 | Astrid Roman | Dietitian, Registered | 8020 Hillside Cv, Memphis, MS 38119 | 2015-09-25 |
| 1467857664 | Allan Jacob Katz | Counselor | 5668 Rex Rd, Suite 104, Memphis, TN 38119 | 2014-10-30 |
| 1962836015 | Judy Ann Harrick | Acupuncturist | 5575 Poplar Ave., #702, Memphis, TN 38119 | 2013-08-26 |
| 1366791949 | Jennifer Denyes Bidelman | Audiologist | 5625 Poplar Avenue, Memphis, TN 38119 | 2012-08-29 |
| 1578833620 | Elizabeth Mary Dion-douglass | Pharmacist | 2891 Kirby Parkway, Memphis, TN 38119 | 2012-01-06 |
| Find all providers in zip 38119 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164048542 | Opportunities Never End LLC | Counselor | 5629 Falling Bark Dr, Memphis, TN 38134-6671 | 2020-06-22 |
| 1477195451 | Jacqueline Reeves Thomas | Counselor | Memphis Veterans Affairs Medical Center (vamc), 1030 Jefferson Ave, Memphis, TN 38016 | 2019-10-11 |
| 1801444872 | Mary Hilgeman Neal | Counselor | 297 Mary Ann Dr, Memphis, TN 38117-2805 | 2019-09-03 |
| 1134695851 | Savannah Burton | Counselor | 895 S Cooper St Ste 12&3, Memphis, TN 38104-5604 | 2018-10-19 |
| 1205301611 | Britney Bryson | Counselor | 4525 Lunsford Dr, Memphis, TN 38125-3284 | 2018-10-11 |
| 1730663063 | Timothy Terry | Counselor | 1714 Monroe Ave, Memphis, TN 38104-3924 | 2018-09-22 |
| 1154801934 | Elizabeth Marie Vigus | Counselor | 1407 Union Ave Ste 805, Memphis, TN 38104-3642 | 2018-08-21 |
| 1316436439 | Mardrey Alicia Wade Kiles | Counselor | 4440 Bishop Hills Dr, Memphis, TN 38128-7427 | 2018-05-03 |
| 1801399191 | Crysta Michelle Nilsson | Counselor | 5118 Park Ave Ste 115, Memphis, TN 38117-5720 | 2018-03-13 |
| 1750897146 | Kelley Goodwin | Counselor | 2023 W Houston Way, Memphis, TN 38139-6933 | 2017-12-20 |
| Find all providers in MEMPHIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.