Healthcare Provider Details

I. General information

NPI: 1285836585
Provider Name (Legal Business Name): JOSEPH W ADAMS JR. MA-COUNSELING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 OLDE TOWNE SQ
CHESTERTON IN
46304-1564
US

IV. Provider business mailing address

824 OLDE TOWNE SQ
CHESTERTON IN
46304-1564
US

V. Phone/Fax

Practice location:
  • Phone: 219-331-4875
  • Fax:
Mailing address:
  • Phone: 219-331-4875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: