MEDICARE: SHELLY ADAMSON COUNSELING LLC

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
1	101YM0800X	Mental Health Counselor	MH5898	FL

General Provider Information

NPI Number	:	1699066688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHELLY ADAMSON COUNSELING LLC

Provider Business Mailing Address
First Line	:	3740 CURTIS BLVD
Second Line	:	SUITE 102
City	:	COCOA
State	:	FL
Zip	:	32927-3962
Country	:	US
Telephone Number	:	321-632-9929
Fax Number	:	321-631-6187

Provider Business Practice Location Address
First Line	:	3740 CURTIS BLVD
Second Line	:	SUITE 102
City	:	COCOA
State	:	FL
Zip	:	32927-3962
Country	:	US
Telephone Number	:	321-632-9929
Fax Number	:	321-631-6187

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	MRS. SHELLY J. ADAMSON
Credential	:	MA, LMHC, NCC
Telephone Number	:	321-632-9929

Provider Enumeration Date	:	04/25/2011
Last Update Date	:	04/25/2011

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