Provider Demographics
NPI:1821448390
Name:ADAMS-YOUNG, SHALONDA NAKIA (PEER SPECIALIST)
Entity Type:Individual
Prefix:
First Name:SHALONDA
Middle Name:NAKIA
Last Name:ADAMS-YOUNG
Suffix:
Gender:M
Credentials:PEER SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 SPRINGDALE RUN DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38108-3342
Mailing Address - Country:US
Mailing Address - Phone:901-314-0856
Mailing Address - Fax:901-805-9400
Practice Address - Street 1:135 N CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-2002
Practice Address - Country:US
Practice Address - Phone:800-274-1843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000017975103TR0400X
TN000-1180175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation