Provider Demographics
NPI:1265021711
Name:LOFFREDO, ADRIENNE LYNN (LCMHCA)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:LYNN
Last Name:LOFFREDO
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 FAIRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-6359
Mailing Address - Country:US
Mailing Address - Phone:336-655-6089
Mailing Address - Fax:
Practice Address - Street 1:100 FAIRIDGE CT
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-6359
Practice Address - Country:US
Practice Address - Phone:336-655-6089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15876101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor