Healthcare Provider Details
I. General information
NPI: 1851443899
Provider Name (Legal Business Name): CARLA ADAMS PH.D., M.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/18/2007
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
913 S COLLEGE RD SUITE 102
LAFAYETTE LA
70503-3060
US
IV. Provider business mailing address
913 S COLLEGE RD SUITE 102
LAFAYETTE LA
70503-3060
US
V. Phone/Fax
- Phone: 337-232-2833
- Fax: 337-234-4038
- Phone: 337-232-2833
- Fax: 337-234-4038
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TB0200X |
| Taxonomy | Cognitive & Behavioral Psychologist |
| License Number | 791 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 791 |
| License Number State | LA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | 791 |
| License Number State | LA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | 791 |
| License Number State | LA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TF0000X |
| Taxonomy | Family Psychologist |
| License Number | 791 |
| License Number State | LA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TM1800X |
| Taxonomy | Intellectual & Developmental Disabilities Psychologist |
| License Number | 791 |
| License Number State | LA |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 791 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: