Provider Demographics
NPI:1336803667
Name:ADEITE, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ADEITE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 DUNCAN CHAPEL RD APT 90
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29617-8222
Mailing Address - Country:US
Mailing Address - Phone:469-230-7706
Mailing Address - Fax:864-281-1332
Practice Address - Street 1:215 DUNCAN CHAPEL RD APT 90
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29617-8222
Practice Address - Country:US
Practice Address - Phone:469-230-7706
Practice Address - Fax:864-281-1332
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC00000101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral