MEDICARE: JABARI ADAMS

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	A10620	NC
2	101YM0800X	Mental Health Counselor	10620	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790197986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JABARI ADAMS

Provider Business Mailing Address
First Line	:	2045 FLUSHING CT
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-4270
Country	:	US
Telephone Number	:	309-255-8336
Fax Number	:

Provider Business Practice Location Address
First Line	:	3717 LATROBE DR STE 740
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-4826
Country	:	US
Telephone Number	:	309-255-8336
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2014
Last Update Date	:	03/27/2020

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Directions to “ JABARI ADAMS ” Practice Location

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