Healthcare Provider Details

I. General information

NPI: 1225527369
Provider Name (Legal Business Name): TINA R. ADAMS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2018
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 ST CLAIR RD
BRIMFIELD MA
01010-2120
US

IV. Provider business mailing address

12 ST CLAIR RD
BRIMFIELD MA
01010-2120
US

V. Phone/Fax

Practice location:
  • Phone: 413-245-1487
  • Fax: 413-245-1629
Mailing address:
  • Phone: 413-245-1487
  • Fax: 413-245-1629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number7790
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7790
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: