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Individual

MS. CHARLENE JEANETTE ADAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICDCCS

Contact information

Practice address
1518 PEARL STREET, SANDUSKY, OH 44870
(419) 515-0663
Mailing address
1518 PEARL ST, SANDUSKY, OH 44870-3038

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
964492
OH
101YP1600X
Pastoral Counselor
100761
OH

Other

Enumeration date
06/13/2017
Last updated
06/13/2017
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