=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932506235
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADAMS AND ASSOCIATES COUNSELING SERVICE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/02/2014
-----------------------------------------------------
Last Update Date | 03/13/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27400 BERKSHIRE DR
-----------------------------------------------------
City | SOUTHFIELD
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48076-4951
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-388-4428
-----------------------------------------------------
Fax | 248-208-9662
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 27400 BERKSHIRE DR
-----------------------------------------------------
City | SOUTHFIELD
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48076-4951
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-388-4428
-----------------------------------------------------
Fax | 248-208-9662
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL THERAPIST
-----------------------------------------------------
Name | MR. HENRY ADAMS
-----------------------------------------------------
Credential | LMSW
-----------------------------------------------------
Telephone | 248-388-4428
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | 6801064655
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------