Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack Stanley Terry

Individual provider Clinical Social Worker · NPI 1134741283

Jack Stanley Terry is a Clinical Social Worker in Northville, Michigan. Practices as a sole proprietor. Licensed in Illinois and Michigan.

Licensed in
IL, MI
In the registry since
2020
Specialties on file
2

Practice location Address checks out

22370 Innsbrook Dr
Northville, MI 48167-9322
Phone: (248) 719-1791
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 6801063118 (MI)
Clinical Social Worker Taxonomy 1041C0700X · Licence 149006760 (IL)

Record details

NPI number1134741283
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 12, 2020
Last updated in NPPESMay 12, 2020
Certification dateMay 12, 2020
Mailing addressPo Box 530564, Livonia, MI 48153-0564

Other providers in Northville