Provider Demographics
NPI:1285151076
Name:ADAMS, SANTANA NIKCOLE (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:SANTANA
Middle Name:NIKCOLE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:MISS
Other - First Name:SANTANA
Other - Middle Name:NIKCOLE
Other - Last Name:DALTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:252 HARRY LANE BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4912
Mailing Address - Country:US
Mailing Address - Phone:865-338-5384
Mailing Address - Fax:865-338-5383
Practice Address - Street 1:207 N BOONE ST STE 605
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-5675
Practice Address - Country:US
Practice Address - Phone:423-328-8260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-23
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TN5911101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty