MEDICARE: DR. LISA G ADAMS PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1083191001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA G ADAMS PHD

Provider Business Mailing Address
First Line	:	32302 W 231ST ST
Second Line	:
City	:	LAWSON
State	:	MO
Zip	:	64062-8159
Country	:	US
Telephone Number	:	913-940-1127
Fax Number	:

Provider Business Practice Location Address
First Line	:	235 E BROADWAY ST
Second Line	:
City	:	EXCELSIOR SPRINGS
State	:	MO
Zip	:	64024-2564
Country	:	US
Telephone Number	:	913-940-1127
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2018
Last Update Date	:	07/23/2018

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