Healthcare Provider Details

I. General information

NPI: 1205179710
Provider Name (Legal Business Name): JANET ADAMS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 07/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4255 WADE GREEN RD NW STE 414
KENNESAW GA
30144-1762
US

IV. Provider business mailing address

5480 MCGINNIS VILLAGE PL STE 104
ALPHARETTA GA
30005-1746
US

V. Phone/Fax

Practice location:
  • Phone: 678-213-2194
  • Fax: 678-922-7767
Mailing address:
  • Phone: 678-213-2194
  • Fax: 678-922-7767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW004859
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: