Healthcare Provider Details

I. General information

NPI: 1245740927
Provider Name (Legal Business Name): LAURICE J ADAMS MA, LCAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2017
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 5TH AVE RM 604
NEW YORK NY
10016-6633
US

IV. Provider business mailing address

2 LEFFLER HILL RD
FLEMINGTON NJ
08822-2608
US

V. Phone/Fax

Practice location:
  • Phone: 917-544-2867
  • Fax:
Mailing address:
  • Phone: 917-544-2867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101200000X
TaxonomyDrama Therapist
License Number000518
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: