Healthcare Provider Details

I. General information

NPI: 1033053574
Provider Name (Legal Business Name): PHILLIP ADAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 05/03/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 E COUNCIL ST STE 6
SALISBURY NC
28144-5075
US

IV. Provider business mailing address

8300 GRANDEUR DR
SALISBURY NC
28146-1635
US

V. Phone/Fax

Practice location:
  • Phone: 704-944-3533
  • Fax: 704-603-3011
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberA22736
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: