Healthcare Provider Details

I. General information

NPI: 1447995741
Provider Name (Legal Business Name): JENNIFER MARIE ADAMS LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2022
Last Update Date: 10/11/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 NILLES RD STE 8
FAIRFIELD OH
45014-7205
US

IV. Provider business mailing address

1840 CLERMONTVILLE LAUREL RD
NEW RICHMOND OH
45157-9618
US

V. Phone/Fax

Practice location:
  • Phone: 513-540-2959
  • Fax: 513-880-0582
Mailing address:
  • Phone: 513-540-2959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberS.2309333
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberI.2608357
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: