Healthcare Provider Details

I. General information

NPI: 1780165027
Provider Name (Legal Business Name): SARAH L ADAMS CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2018
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 TOWNSHIP ROAD 365
SOUTH POINT OH
45680-9409
US

IV. Provider business mailing address

4221 STATE ROUTE 1
GREENUP KY
41144-7978
US

V. Phone/Fax

Practice location:
  • Phone: 740-451-0221
  • Fax:
Mailing address:
  • Phone: 606-371-9288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.164906
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberAPS.005716
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: