Healthcare Provider Details

I. General information

NPI: 1992748859
Provider Name (Legal Business Name): JOJAN MARIE ADAMS L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 FOWLER AVE
BERWICK PA
18603-1423
US

IV. Provider business mailing address

381 KLINE RD
ORANGEVILLE PA
17859-9050
US

V. Phone/Fax

Practice location:
  • Phone: 570-322-7873
  • Fax: 570-322-8026
Mailing address:
  • Phone: 570-322-7873
  • Fax: 570-322-8026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW012539
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: