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NPI Code Detail

MEDICARE: MR. ADAM JEFFRYES MA, LPC

MEDICARE: MR. ADAM JEFFRYES MA, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLPC.0015704CO

General Provider Information

NPI Number : 1477160885
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ADAM JEFFRYES MA, LPC
Provider Business Mailing Address
First Line : 19 E ABARR DR
Second Line :
City : PUEBLO
State : CO
Zip : 81007-5436
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19 E ABARR DR
Second Line :
City : PUEBLO
State : CO
Zip : 81007-5436
Country : US
Telephone Number : 719-688-8984
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2020
Last Update Date : 09/29/2020

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