Provider Demographics
NPI:1023027760
Name:ADAMS, MARLENE JUDITH (LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:JUDITH
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 INDEPENDENCE CIR
Mailing Address - Street 2:SUITE 3D
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-6405
Mailing Address - Country:US
Mailing Address - Phone:757-473-8533
Mailing Address - Fax:757-456-0616
Practice Address - Street 1:700 INDEPENDENCE CIR
Practice Address - Street 2:SUITE 3D
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6405
Practice Address - Country:US
Practice Address - Phone:757-473-8533
Practice Address - Fax:757-456-0616
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001164101YP2500X
VA0717000231106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAO80075OtherOPTIMA/ SENTARA
VA093371OtherANTHEM
VA005402271Medicaid