Provider Demographics
NPI:1831618453
Name:ADAMS, STACEY PARRAMORE
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:PARRAMORE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:HAHIRA
Mailing Address - State:GA
Mailing Address - Zip Code:31632-1544
Mailing Address - Country:US
Mailing Address - Phone:229-444-2957
Mailing Address - Fax:
Practice Address - Street 1:616 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:HAHIRA
Practice Address - State:GA
Practice Address - Zip Code:31632-1544
Practice Address - Country:US
Practice Address - Phone:229-375-7127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-14
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22328101YP2500X
171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional