Nicole Adams, LMHC

Individual provider Active NPI Professional Counselor · Gautier, MS

NPI 1992196034 · NPPES record last updated Jun 29, 2016

Key facts

NPI
1992196034
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
0177821 (NM)
Practice address
3407 Shamrock CT
Gautier, MS 39553-5337
Phone
(228) 497-0690
NPI assigned
Feb 11, 2015
Sex
Female
Sole proprietor
Yes

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
0177821NMMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0177821 NM Yes
Mental Health Counselor 101YM0800X 0177821 NM

Addresses

Primary practice location

3407 Shamrock CT
Gautier, MS 39553-5337

Mailing address

3407 Shamrock CT
Gautier, MS 39553-5337
Phone (228) 497-0690

Other providers in Gautier, MS

All providers in Gautier, MS · Professional Counselor in Mississippi

Sources for this page

Verify at the official NPI Registry.