Albertha J Adcock, CAC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Lake Charles, LA

NPI 1184896763 · NPPES record last updated Aug 4, 2022

Key facts

NPI
1184896763
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
1293 (LA)
Practice address
4105 Kirkman St
Lake Charles, LA 70607-4603
Phone
(337) 475-8022
Fax
(337) 475-8054
NPI assigned
Mar 24, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1293LAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Calcasieu Human Services Authority Past Accepting new patients
Palmetto Addiction Recovery Center, Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1293 LA Yes

Addresses

Primary practice location

4105 Kirkman St
Lake Charles, LA 70607-4603

Mailing address

1851 Fox Run Dr Apt 1
Lake Charles, LA 70605-6421
Phone (337) 794-7237

Other providers in Lake Charles, LA

All providers in Lake Charles, LA · Addiction (Substance Use Disorder) Counselor in Louisiana

Sources for this page

Verify at the official NPI Registry.