Healthcare Provider Details

I. General information

NPI: 1285151076
Provider Name (Legal Business Name): SANTANA NIKCOLE ADAMS MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS SANTANA NIKCOLE DALTON

II. Dates (important events)

Enumeration Date: 08/23/2017
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 N BOONE ST STE 13
JOHNSON CITY TN
37604-5659
US

IV. Provider business mailing address

9041 EXECUTIVE PARK DR STE 275B
KNOXVILLE TN
37923-4621
US

V. Phone/Fax

Practice location:
  • Phone: 423-328-8260
  • Fax:
Mailing address:
  • Phone: 865-338-5384
  • Fax: 865-338-5383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5911
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: