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NPI Code Detail

MEDICARE: MR. JOHNNY M ADAMS LCSW

MEDICARE: MR. JOHNNY M 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
1104100000XSocial Worker514366TX

General Provider Information

NPI Number : 1831247261
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHNNY M ADAMS LCSW
Provider Business Mailing Address
First Line : 3502 22ND ST
Second Line :
City : LUBBOCK
State : TX
Zip : 79410-1308
Country : US
Telephone Number : 806-771-5595
Fax Number : 806-799-6299
Provider Business Practice Location Address
First Line : 3502 22ND ST
Second Line :
City : LUBBOCK
State : TX
Zip : 79410-1308
Country : US
Telephone Number : 806-771-5595
Fax Number : 806-799-6299
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 07/08/2007

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