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General NPI Number Information
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NPI Number | 1114471554
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Entity Type | Individual
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Provider Name | STEPHANIE ADAMS B.A. MHP
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Gender | Female
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Dates
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Enumeration Date | 08/13/2016
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Last Update Date | 08/13/2016
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Provider Practice Location Address
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Address Line | 2160 S 6TH ST
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City | SPRINGFIELD
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State | IL
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Zip | 62703-3459
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Country | US
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Telephone | 217-528-9829
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Fax | 217-528-9823
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Provider Business Mailing Address
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Address Line | 1110 N RUTLEDGE ST
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City | SPRINGFIELD
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State | IL
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Zip | 62702-2523
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Country | US
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Telephone | 217-638-1195
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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