Healthcare Provider Details

I. General information

NPI: 1871406603
Provider Name (Legal Business Name): KIANNA DELLECIA ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 SHUGART RD
DALTON GA
30720-2467
US

IV. Provider business mailing address

23 CHESTNUT RIDGE RD
RINGGOLD GA
30736-2990
US

V. Phone/Fax

Practice location:
  • Phone: 706-270-5100
  • Fax:
Mailing address:
  • Phone: 706-934-6758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC17456
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: