=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457089583
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADAMS BEHAVIORAL CONSULTING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2022
-----------------------------------------------------
Last Update Date | 10/05/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1603 MANCHESTER DR SW
-----------------------------------------------------
City | CONYERS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30094-4088
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-808-2285
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1603 MANCHESTER DR SW
-----------------------------------------------------
City | CONYERS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30094-4088
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-808-2285
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JOSEPH ADAMS
-----------------------------------------------------
Credential | BCBA
-----------------------------------------------------
Telephone | 404-808-7246
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------