Healthcare Provider Details

I. General information

NPI: 1366914731
Provider Name (Legal Business Name): MICHELE ADAMS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2018
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 BROADWAY # D10-36
ELMHURST NY
11373-1329
US

IV. Provider business mailing address

7901 BROADWAY # D10-36
ELMHURST NY
11373-1329
US

V. Phone/Fax

Practice location:
  • Phone: 718-334-3501
  • Fax: 718-334-5006
Mailing address:
  • Phone: 718-334-3501
  • Fax: 718-334-5006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number119452
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number104032
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: