Healthcare Provider Details

I. General information

NPI: 1255683090
Provider Name (Legal Business Name): DENISE M. ADAMS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DENISE M. ADAMS LCSW

II. Dates (important events)

Enumeration Date: 10/03/2012
Last Update Date: 12/22/2021
Certification Date: 12/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 S VERMONT AVE
LOS ANGELES CA
90020-1992
US

IV. Provider business mailing address

510 S. VERMONT AVENUE
LA CA
90044
US

V. Phone/Fax

Practice location:
  • Phone: 800-854-7771
  • Fax:
Mailing address:
  • Phone: 800-854-7771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS27750
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number699
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: