Provider Demographics
NPI:1013594415
Name:ADAMS, MARY SUE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:SUE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:MARYSUE
Other - Middle Name:MAIN
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:835 PRIDE DR STE B
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-9527
Mailing Address - Country:US
Mailing Address - Phone:985-543-4333
Mailing Address - Fax:
Practice Address - Street 1:835 PRIDE DR STE B
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-9527
Practice Address - Country:US
Practice Address - Phone:985-543-4333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16109104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker