TERRI MARTIN REVELLE


Address: 111 E. Jefferson St., Jackson, NC 27845
Phone: 2525783918

TERRI MARTIN REVELLE (NPI# 1013109552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013109552
Entity Type Individual
Full Name TERRI MARTIN REVELLE
Credential MA, LPA
Practice Address 111 E. Jefferson St.
Jackson
NC 27845
Mailing Address 518 Pine Tops Rd
Murfreesboro
NC 27855-9663
Practice Telephone 2525783918
Practice Fax Number 2525341216
Mailing Telephone 2525783918
Enumeration Date 2007-08-17
Last Update Date 2015-01-16
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist 3749 NC Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
NC BLUE CROSS BLUE SHIELD 157CH 01
NC 6107657 05

Office Location

Street Address 111 E. JEFFERSON ST.
City JACKSON
State NC
Zip Code 27845

Providers in the same zip code

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1114483674 Sarah Beatrice Robinson Speech-Language Pathologist 200 Hampton Woods Road, Jackson, NC 27845 2019-02-20
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1699002923 Cnc/access Inc Community/Behavioral Health 9486 Nc Highway 305, Jackson, NC 27845 2009-11-06
1881890424 Northampton County Dss Public Health or Welfare 9467 Nc 305 Hwy., Jackson, NC 27845 2007-06-21
1588868400 Northampton County Ambulance 132 Landfeild Road, Jackson, NC 27845 2007-06-13
1689626178 Rural Health Group, Inc. Clinic/Center 9425 Nc 305 Hwy, Jackson, NC 27845 2006-05-16
1538687132 Shatoya Ronique Joyner Social Worker 9486 Nc Highway 305, Jackson, NC 27845 2017-09-03
1760707996 Integrated Family Services, Pllc Social Worker 9486 Nc Hwy 305, Jackson, NC 27845 2010-03-31
1659538825 Megan Kathleen Farrelly Dentist 9409 Nc Hwy 305, Jackson, NC 27845 2008-05-16
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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Notes: Source: American Psychological Association [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144792169 Snake River Consulting LLC Psychologist 430 Pine Dr, Jackson, WY 83001-8417 2019-01-02
1972834604 Sue C Radtke Psychologist 4476 Bittersweet Ct, Jackson, WI 53037-9754 2010-01-20
1043549280 University of Mississippi Medical Center Psychologist 2500 N State St # H819-01, Jackson, MS 39216-4500 2009-12-17
1356511562 John Patterson Thorn Psychologist 270 Veronica Lane, Suite C-1, Jackson, WY 83001-0000 2008-03-04
1184830143 Toby S Altfeld Psychologist 156 C West University Parkway, Jackson, TN 38305 2007-05-15
1497968911 Mollie Wyatt Psychologist 4055 I-55 North, Suite 293, Jackson, MS 39211 2007-05-08
1124249719 John David Vickery Psychologist 3363 Highway 45 North, Jackson, TN 38305 2007-05-01
1215157425 Angela O'briant Herzog Psychologist Forty-five Hundred Interstate Fifty-five North, Suite 208, Jackson, MS 39211 2007-04-27
1295877165 Rose Margaret Hochheiser Psychologist 140 King Street, Jackson, WY 83001 2007-02-13
1932253291 Julia Goldensohn Psychologist 610 W. Broadway, Lo2g, Jackson, WY 83001 2007-01-23
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Competitor

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City JACKSON
Zip Code 27845

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Dataset Information

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.

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