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General NPI Number Information
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NPI Number | 1124307194
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Entity Type | Organization
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Legal Business Name | TALBOT ADAMS COUNSELING, LLC
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Dates
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Enumeration Date | 08/09/2011
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Last Update Date | 08/09/2011
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Provider Practice Location Address
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Address Line | 401 JACKSON AVE E
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City | OXFORD
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State | MS
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Zip | 38655-3809
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Country | US
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Telephone | 662-801-4249
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Fax |
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Provider Business Mailing Address
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Address Line | 401 JACKSON AVE E
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City | OXFORD
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State | MS
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Zip | 38655-3809
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Country | US
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Telephone | 662-801-4249
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST / MEMBER / MANAGER
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Name | MR. JESSE TALBOT ADAMS
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Credential | LCSW
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Telephone | 662-801-4249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | C5529
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License Number State | MS
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