Provider Demographics
NPI:1043738016
Name:ADAMS, NETRA (LISW-CP)
Entity Type:Individual
Prefix:
First Name:NETRA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 PRIVET CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-9093
Mailing Address - Country:US
Mailing Address - Phone:803-446-6949
Mailing Address - Fax:
Practice Address - Street 1:610 FAISON DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-3218
Practice Address - Country:US
Practice Address - Phone:803-935-5917
Practice Address - Fax:803-935-5823
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-30
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC102591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical