MEDICARE: MS. ANDREA JO LYNNE ADAMS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	101YM0800X	Mental Health Counselor	IN
2	101Y00000X	Counselor	IN
3	106E00000X	Assistant Behavior Analyst	IN
4	106S00000X	Behavior Technician	IN
5	171M00000X	Case Manager/Care Coordinator	IN
6	172V00000X	Community Health Worker	IN
7	225C00000X	Rehabilitation Counselor	IN
8	251B00000X	Case Management Agency
9	251E00000X	Home Health Agency	IN
10	251S00000X	Community/Behavioral Health Agency
11	261QA0600X	Adult Day Care Clinic/Center
12	385H00000X	Respite Care
13	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care	IN
14	261QM0855X	Adolescent and Children Mental Health Clinic/Center	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	85-0938219	OTHER	IN	AT HOME WITH ANGEL EYE'S LLC

General Provider Information

NPI Number	:	1952025025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANDREA JO LYNNE ADAMS

Provider Business Mailing Address
First Line	:	5415 E 34TH ST STE C
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-2403
Country	:	US
Telephone Number	:	463-224-0562
Fax Number	:

Provider Business Practice Location Address
First Line	:	5415 E 34TH ST STE C
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-2403
Country	:	US
Telephone Number	:	463-224-0562
Fax Number	:

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

Provider Enumeration Date	:	10/03/2022
Last Update Date	:	03/17/2025

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