Provider Demographics
NPI:1154157204
Name:ADKINS, TINA (PHD, LPC)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:ADKINS
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8644 SANDERLING DR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-5849
Mailing Address - Country:US
Mailing Address - Phone:512-366-2301
Mailing Address - Fax:
Practice Address - Street 1:8644 SANDERLING DR
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-5849
Practice Address - Country:US
Practice Address - Phone:512-366-2301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80452101YM0800X
VA0701013870101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health