Provider Demographics
NPI:1679088066
Name:MCCOLLUM-SMIT, ADRIENNE (LICSW-S)
Entity Type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:
Last Name:MCCOLLUM-SMIT
Suffix:
Gender:F
Credentials:LICSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CHASE PARK S STE 102
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1884
Mailing Address - Country:US
Mailing Address - Phone:205-728-3949
Mailing Address - Fax:251-207-3352
Practice Address - Street 1:711 WADSWORTH ST UNIT 200
Practice Address - Street 2:
Practice Address - City:MONTEVALLO
Practice Address - State:AL
Practice Address - Zip Code:35115-3531
Practice Address - Country:US
Practice Address - Phone:205-728-3949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-06
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4026C-S1041C0700X
AL4026C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty