MEDICARE: MRS. OLABISI ADAMS LCSW

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	1041C0700X	Clinical Social Worker	58319	TX

General Provider Information

NPI Number	:	1396214771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. OLABISI ADAMS LCSW

Provider Business Mailing Address
First Line	:	PO BOX 800333
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75380-0333
Country	:	US
Telephone Number	:	917-640-4146
Fax Number	:

Provider Business Practice Location Address
First Line	:	509 ROCKY SPRINGS DR
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-7755
Country	:	US
Telephone Number	:	870-518-4430
Fax Number	:

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

Provider Enumeration Date	:	11/15/2018
Last Update Date	:	11/15/2018

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