MEDICARE: MRS. MICHELLE ADAMS MSW CSW

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	6516	KY

General Provider Information

NPI Number	:	1891108411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE ADAMS MSW CSW

Provider Business Mailing Address
First Line	:	1050 DELLA DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-2219
Country	:	US
Telephone Number	:	859-913-4862
Fax Number	:

Provider Business Practice Location Address
First Line	:	3150 CUSTER DR STE 103
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40517-4010
Country	:	US
Telephone Number	:	859-971-2585
Fax Number	:

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

Provider Enumeration Date	:	06/11/2014
Last Update Date	:	06/11/2014

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