Healthcare Provider Details
I. General information
NPI: 1467560102
Provider Name (Legal Business Name): ADAMS COUNSELING AND ASSESSMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 PLAZA DR SUITE 6
PENDLETON IN
46064-8823
US
IV. Provider business mailing address
1 PLAZA DR SUITE 6
PENDLETON IN
46064-8823
US
V. Phone/Fax
- Phone: 765-778-0380
- Fax: 765-778-8328
- Phone: 765-778-0380
- Fax: 765-778-8328
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROB
ADAMS
Title or Position: OWNER
Credential: LCSW, NCSP
Phone: 765-778-0380