Provider Demographics
NPI:1669942769
Name:SIFFORD, ADRIANNA PAYNE (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:PAYNE
Last Name:SIFFORD
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 HICKORY DR NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-3626
Mailing Address - Country:US
Mailing Address - Phone:870-253-2508
Mailing Address - Fax:
Practice Address - Street 1:2800 WESTSIDE DR NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3501
Practice Address - Country:US
Practice Address - Phone:423-339-4252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4472101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health