MS. DERONDA VYNETTE TERRY LPC
NPI 1639265085
Counselor - Professional in Memphis, TN

Active since October 05, 2006PECOS EnrolledAccepts Medicare Assignment
6005 PARK AVE STE 630B, MEMPHIS, TN 38119(901) 767-1136 Get Directions Write a Review

NPPES record last updated: September 19, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ms. Deronda Vynette Terry Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. DERONDA VYNETTE TERRY LPC (NPI 1639265085) is an individual professional provider in Memphis, Tennessee and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS, maintains a secondary practice location in Memphis, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1639265085
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMS. DERONDA VYNETTE TERRYCredential: LPC
Location Address6005 PARK AVE STE 630BMemphis, TN 38119-5226
Mailing Address6005 Park Ave Ste 630bMemphis, TN 38119-5226 · (901) 767-1136
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateOctober 5, 2006
Last NPPES UpdateSeptember 19, 2018
✔ NPI 1639265085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Also ListedCounselorTaxonomy 101Y00000X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
6005 PARK AVE STE 630B, Memphis, TN 38119

Other Names 1

Former Name (1)Mrs. Deronda Vynette King Mac

Secondary Practice Location 1

Location 13810 Winchester Rd, Southeast Mental Health CenterMemphis, TN 38118-9007 · Phone (901) 369-1420 · Fax (901) 369-1433

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Deronda Vynette Terry Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971047622
PECOS Enrollment IDI20240705000437
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Deronda Terry reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Case Management
3171 DIRECTORS ROW
Memphis, TN 38131
  • Reassigned Medicare billing, Tennessee enrollment
  • 16 clinicians in this Medicare group
Psychologist
1250 FARROW RD
Memphis, TN 38116
  • Reassigned Medicare billing, Tennessee enrollment
  • 72 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Psychiatric/Mental Health)
6005 PARK AVE STE 630B
MEMPHIS, TN 38119
Nurse Practitioner (Psychiatric/Mental Health)
6005 PARK AVE STE 630B
MEMPHIS, TN 38119
Nurse Practitioner (Psychiatric/Mental Health)
6005 PARK AVE STE 630B
MEMPHIS, TN 38119
Nurse Practitioner (Psychiatric/Mental Health)
6005 PARK AVE STE 630B
MEMPHIS, TN 38119
Psychiatry & Neurology (Psychiatry)
6005 PARK AVE STE 630B
MEMPHIS, TN 38119
Nurse Practitioner (Psychiatric/Mental Health)
6005 PARK AVE STE 630B
MEMPHIS, TN 38119
Nurse Practitioner (Psychiatric/Mental Health)
6005 PARK AVE STE 630B
MEMPHIS, TN 38119
Clinical Nurse Specialist (Psychiatric/Mental Health, Child & Family)
6005 PARK AVE STE 630B
MEMPHIS, TN 38119

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deronda Terry's NPI number?

The NPI number for Deronda Terry is 1639265085. It was assigned to this individual provider in the NPPES registry on October 5, 2006. The provider is also known as Mrs. Deronda Vynette King Mac.

Where is Deronda Terry located?

Deronda Terry practices at 6005 Park Ave Ste 630B, Memphis, TN 38119. The listed phone number is (901) 767-1136.

What is Deronda Terry's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Deronda Terry enrolled in Medicare?

Yes. Deronda Terry is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Deronda Terry's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Deronda Terry reassigns Medicare benefits to 2 organizations: Case Management Inc (Memphis, TN) and Step Up Care Of Tennessee LLC (Memphis, TN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Deronda Terry's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Deronda Terry accept?

Health plans from BlueCross BlueShield of Tennessee, Cigna Healthcare, Oscar Insurance Company and UnitedHealthcare list Deronda Terry as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Deronda Terry was last updated on September 19, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.