Individual
MRS. JACQUELINE ADAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PCMHT
Contact information
Practice address
1654 E UNION ST, GREENVILLE, MS 38703-3250
(662) 335-5274
(662) 378-3976
Mailing address
1654 E UNION ST, GREENVILLE, MS 38703-3250
(662) 335-5274
(662) 378-3976
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
1927
MS
101YM0800X
Mental Health Counselor
Primary
1927
MS
101YP2500X
Professional Counselor
1927
MS
104100000X
Social Worker
1927
MS
1041C0700X
Clinical Social Worker
1927
MS
106H00000X
Marriage & Family Therapist
1927
MS
Other
Enumeration date
08/19/2010
Last updated
08/19/2010
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