| Doctor Name: | MR. TERRENCE M LONERGAN |
| NPI Number: | 1053349076 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA |
| License Number: | MH4348 |
| Business Practice Address: | 5400 S Biscayne Dr Suite A North Port, FL - 342871932 |
| Business Phone Number: | 9414296100 |
| Business Fax Number: | 9414269147 |
| Mailing Address: | 4250 Seafox Rd, VENICE |
| State: | FL |
| Postal Code: | 342935646 |
| Phone Number: | 9414296100 |
| Fax Number: | 9414269147 |
| NPI Enumeration Date: | 06/29/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | MH4348 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |