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General NPI Number Information
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NPI Number | 1215062229
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Entity Type | Individual
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Provider Name | LYNDA MARIE LOFTIS LADAC
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Gender | Female
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/13/2018
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Provider Practice Location Address
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Address Line | 2435 OAK PARK DR
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City | COOKEVILLE
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State | TN
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Zip | 38506
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Country | US
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Telephone | 931-510-9775
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Fax | 615-528-9403
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Provider Business Mailing Address
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Address Line | 2435 OAK PARK DR
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City | COOKEVILLE
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State | TN
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Zip | 38506-5038
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Country | US
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Telephone | 931-510-9775
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1118
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1118
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number | 079962201
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | 0330
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License Number State | TN
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Taxonomy #7
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1118
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License Number State | TN
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Taxonomy #10
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | 079962201
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License Number State | TN
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Taxonomy #13
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number | 1118
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License Number State | TN
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Taxonomy #15
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1118
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License Number State | TN
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