Adeline McTavous, PH.D., LPC, LMHC,CCS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC3272 Issued in MD

Practice address

555 Charlie Smith Sr Hwy Ste 6
Saint Marys, GA 31558

Phone

(912) 576-0187

Fax

(912) 576-9690

NPI assigned

Mar 9, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1124341854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 CHARLIE SMITH SR HWY STE 6",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583032",
            "telephone_number": "912-576-0187",
            "fax_number": "912-576-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 CHARLIE SMITH SR HWY STE 6",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "31558",
            "telephone_number": "912-576-0187",
            "fax_number": "912-576-9690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1205 4th St",
            "address_purpose": "LOCATION",
            "city": "Key West",
            "state": "FL",
            "postal_code": "330403707",
            "country_code": "US",
            "telephone_number": "305-434-7660 x31209",
            "fax_number": "305-292-6723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCTAVOUS",
        "first_name": "ADELINE",
        "name_prefix": "Dr.",
        "credential": "PH.D., LPC, LMHC,CCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-09",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC3272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Saint Marys, GA
• Providers in Saint Marys, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.