MR. CHRISTOPER MAURICE LYLE LADAC II
NPI 1003643115
Counselor - Addiction (Substance Use Disorder) in Cordova, TN
Active since September 14, 2024
About Mr. Christoper Maurice Lyle Ladac Ii NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. CHRISTOPER MAURICE LYLE LADAC II (NPI 1003643115) is an individual addiction (substance use disorder) provider in Cordova, Tennessee, licensed in Tennessee (1628) and active in the NPI registry since September 2024.
NPPES Registry Identity
NPI1003643115
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. CHRISTOPER MAURICE LYLECredential: LADAC II
Location Address912 DALEMORE LNCordova, TN 38018-8238
Mailing Address912 Dalemore LnCordova, TN 38018-8238 · (901) 653-8352
Phone(901) 653-8352
Sole ProprietorYes
Enumeration DateSeptember 14, 2024
NPPES CertifiedSeptember 14, 2024
✔ NPI 1003643115 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in TN · 1628
912 DALEMORE LN, Cordova, TN 38018
Group Practice 1
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003643115, enumerated as an "individual" on September 14, 2024.
The provider is located at 912 DALEMORE LN CORDOVA, TN 38018 and the phone number is (901) 653-8352.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
