Provider Demographics
NPI:1063838431
Name:WEBSTER, ADAM MICHAEL (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:MICHAEL
Last Name:WEBSTER
Suffix:
Gender:M
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3849 US HWY 127
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MTN
Mailing Address - State:TN
Mailing Address - Zip Code:37377
Mailing Address - Country:US
Mailing Address - Phone:423-593-8502
Mailing Address - Fax:
Practice Address - Street 1:3849 US HWY 127 N
Practice Address - Street 2:
Practice Address - City:SIGNAL MTN
Practice Address - State:TN
Practice Address - Zip Code:37377
Practice Address - Country:US
Practice Address - Phone:423-593-8502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3105101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional