Healthcare Provider Details

I. General information

NPI: 1306648118
Provider Name (Legal Business Name): REBECCA CAROL ADAMS MSW, LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 HUDGINS ST
LOGAN WV
25601-3535
US

IV. Provider business mailing address

1404 RACE ST STE 302
CINCINNATI OH
45202-7366
US

V. Phone/Fax

Practice location:
  • Phone: 304-752-7830
  • Fax:
Mailing address:
  • Phone: 304-784-0342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberBP00942483
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: