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Individual

MRS. ANGELA MARIE ADAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
4123 DUTCHMANS LANE, SUITE 515, LOUISVILLE, KY 40207-4730
(502) 899-6907
(502) 899-6905
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
Primary
4055
KY
1041C0700X
Clinical Social Worker
5019
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001001629
ANTHEM
KY
01
208681
SIHO
KY
01
50100202
PASSPORT
KY
05
7100380070
KY
Enumeration date
03/02/2007
Last updated
07/11/2023
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