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General NPI Number Information
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NPI Number | 1912879354
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Entity Type | Individual
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Provider Name | ADRIAN SURRATT
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Gender | Male
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 823 ELM ST STE 234
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-4172
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Country | US
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Telephone | 910-236-2061
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Fax |
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Provider Business Mailing Address
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Address Line | 140 W SALTGRASS LN
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City | SMITHFIELD
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State | NC
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Zip | 27577-3400
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Country | US
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Telephone | 239-896-7227
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | A22068
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License Number State | NC
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