Individual
MR. TERRY P. MCDONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
4276 LEGEND AVENUE, FAYETTEVILLE, NC 28303-1965
(910) 867-0545
Mailing address
P.O. BOX 425, WHITEVILLE, NC 28472-0425
(910) 641-0600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1424
NC
101YP2500X
Professional Counselor
180005464
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6112106
—
NC
Enumeration date
06/04/2008
Last updated
03/21/2011
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