| Doctor Name: | DR. ADELINE MCTAVOUS |
| NPI Number: | 1124341854 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D., LCPC, CTS |
| License Number: | LC3272 |
| Business Practice Address: | 1205 4th St Key West, FL - 330403707 |
| Business Phone Number: | 3054347660 |
| Business Fax Number: | 3052926723 |
| Mailing Address: | 1205 4th St, KEY WEST |
| State: | FL |
| Postal Code: | 330403707 |
| Phone Number: | 3054347660 |
| Fax Number: | 3052926723 |
| NPI Enumeration Date: | 03/09/2010 |
| NPI Last Update Date: | 05/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LC3272 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |