MEDICARE: MS. TIJUANA P ADAMS MS, LPC, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	8380	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376806257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TIJUANA P ADAMS MS, LPC, NCC

Provider Business Mailing Address
First Line	:	3011 S MEMORIAL DR STE 5
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-6238
Country	:	US
Telephone Number	:	252-364-6007
Fax Number	:	888-509-1504

Provider Business Practice Location Address
First Line	:	3011 S MEMORIAL DR STE 5
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-6238
Country	:	US
Telephone Number	:	252-364-6007
Fax Number	:	888-509-1504

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2012
Last Update Date	:	03/01/2014

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