Provider Demographics
NPI:1003024431
Name:ADAMS, VIRGINIA M (LMHC)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:M
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:GINNY
Other - Middle Name:
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:8140 PARK STATE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46815-6628
Mailing Address - Country:US
Mailing Address - Phone:260-705-3780
Mailing Address - Fax:
Practice Address - Street 1:200 HOOSIER DR STE E
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:IN
Practice Address - Zip Code:46703-9349
Practice Address - Country:US
Practice Address - Phone:260-665-9494
Practice Address - Fax:260-705-9496
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001836A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health