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General NPI Number Information
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NPI Number | 1649959040
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Entity Type | Organization
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Legal Business Name | MALLORY ADAMS COUNSELING, LLC
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Dates
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Enumeration Date | 07/13/2023
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 221 RUE DE JEAN STE 100
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City | LAFAYETTE
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State | LA
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Zip | 70508-8501
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Country | US
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Telephone | 337-484-3166
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Fax |
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Provider Business Mailing Address
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Address Line | 104 ABERCROMBIE WAY
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City | YOUNGSVILLE
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State | LA
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Zip | 70592-6895
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Country | US
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Telephone | 318-547-1402
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Fax |
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Authorized Official
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Title or Position | OWNER, CINICIAN
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Name | MALLORY D ADAMS
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Credential | LPC
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Telephone | 256-503-9990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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