MEDICARE: DARRELL DENESE ADAMS LPC

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	101YP2500X	Professional Counselor	LPC05335	AL

General Provider Information

NPI Number	:	1710792916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARRELL DENESE ADAMS LPC

Provider Business Mailing Address
First Line	:	3400 VISTA GRANDE DR
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36303-1154
Country	:	US
Telephone Number	:	334-379-8914
Fax Number	:

Provider Business Practice Location Address
First Line	:	3400 VISTA GRANDE DR
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36303-1154
Country	:	US
Telephone Number	:	334-379-8914
Fax Number	:

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

Provider Enumeration Date	:	02/12/2025
Last Update Date	:	02/12/2025

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Directions to “ DARRELL DENESE ADAMS LPC” Practice Location

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