Individual provider Active NPI

Adia Shaniqua Fields-Udofia

  • Mental Health Counselor
  • Stone Mountain, GA
National Provider Identifier
1356203863
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
014456 Issued in GA
Practice address
4600 Rockbridge Rd Ste D
Stone Mountain, GA 30083-7312
Phone
(678) 689-8481
NPI assigned
Dec 2, 2025
Last updated
Dec 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 014456 GA Primary

Addresses

Primary practice location

4600 Rockbridge Rd Ste D
Stone Mountain, GA 30083-7312

Mailing address

PO Box 674122
Marietta, GA 30006-0069
Phone (678) 689-8481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260520000663 GA Practitioner - Mental Health Counselor 5991274821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

135 Governors SQ
Suite C
Peachtree City, GA 30269-4860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014456GAMDMental Health Counselor

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1764633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1356203863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674122",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300060069",
            "telephone_number": "678-689-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 ROCKBRIDGE RD STE D",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300837312",
            "telephone_number": "678-689-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDS-UDOFIA",
        "first_name": "ADIA",
        "middle_name": "SHANIQUA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-02",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "014456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

Verify at the official NPI Registry.