=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467112995
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TIFFANI LAKESHIA ADAMS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/24/2021
-----------------------------------------------------
Last Update Date | 12/28/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3929 AIRPORT BLVD STE 310
-----------------------------------------------------
City | MOBILE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36609-1987
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 251-414-3599
-----------------------------------------------------
Fax | 251-217-4624
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3929 AIRPORT BLVD STE 310
-----------------------------------------------------
City | MOBILE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36609-1987
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 251-414-3599
-----------------------------------------------------
Fax | 251-217-4624
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | C2578A
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------