Healthcare Provider Details
I. General information
NPI: 1528777117
Provider Name (Legal Business Name): ADAM MAYFIELD MA, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/22/2022
Last Update Date: 11/22/2022
Certification Date: 11/22/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
331 SHAW AVE FL 2
MCKEESPORT PA
15132-2918
US
IV. Provider business mailing address
331 SHAW AVE FL 2
MCKEESPORT PA
15132-2918
US
V. Phone/Fax
- Phone: 412-427-3809
- Fax:
- Phone: 412-427-3809
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: