Healthcare Provider Details

I. General information

NPI: 1164662938
Provider Name (Legal Business Name): PAULA LYNN ADAMS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2009
Last Update Date: 09/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7327 KAINER SPRINGS LN
RICHMOND TX
77407-6392
US

IV. Provider business mailing address

7327 KAINER SPRINGS LN
RICHMOND TX
77407-6392
US

V. Phone/Fax

Practice location:
  • Phone: 505-801-4516
  • Fax:
Mailing address:
  • Phone: 505-801-4516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number0092971
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number61439
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0092971
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-08159
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: