MEDICARE: KAYLA VOORHEES ADAMS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	L14288	OR
2	1041C0700X	Clinical Social Worker	53552	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	L14288	OTHER	OR	LCSW
2	53552	OTHER	TX	LCSW

General Provider Information

NPI Number	:	1336614221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA VOORHEES ADAMS LCSW

Provider Business Mailing Address
First Line	:	3309 FOREST CREEK DR UNIT 103A
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-6168
Country	:	US
Telephone Number	:	806-341-9141
Fax Number	:	806-403-3151

Provider Business Practice Location Address
First Line	:	3309 FOREST CREEK DR UNIT 103A
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-6168
Country	:	US
Telephone Number	:	806-341-9141
Fax Number	:	806-403-3151

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2018
Last Update Date	:	11/12/2024

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