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General NPI Number Information
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NPI Number | 1932834785
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Entity Type | Individual
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Provider Name | BLAKE ADAMS LPC
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Gender | Female
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Dates
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Enumeration Date | 07/17/2022
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 4047 CENTER AVE
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City | LYONS
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State | IL
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Zip | 60534-1315
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Country | US
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Telephone | 773-425-1232
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 621
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City | WILLOW SPRINGS
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State | IL
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Zip | 60480-0621
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178.015522
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License Number State | IL
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