Provider Demographics
NPI:1598148850
Name:HARRELL, ADRIANNA (LCSW)
Entity Type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:
Last Name:HARRELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ADRIANNA
Other - Middle Name:
Other - Last Name:HARRELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:401 MOYE BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-2885
Mailing Address - Country:US
Mailing Address - Phone:252-830-2149
Mailing Address - Fax:
Practice Address - Street 1:7050 AIR DEPOT BLVD
Practice Address - Street 2:
Practice Address - City:TINKER AFB
Practice Address - State:OK
Practice Address - Zip Code:73145
Practice Address - Country:US
Practice Address - Phone:405-582-6603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-06
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0108811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical