Healthcare Provider Details

I. General information

NPI: 1639641368
Provider Name (Legal Business Name): ELIZABETH ADAMS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2018
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N 2ND ST
RATON NM
87740-3803
US

IV. Provider business mailing address

224 E 6TH ST
CIMARRON NM
87714-4004
US

V. Phone/Fax

Practice location:
  • Phone: 575-445-7078
  • Fax:
Mailing address:
  • Phone: 903-949-0158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2026-0763
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2026-0763
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: