Provider Demographics
NPI:1043755135
Name:DEVANEY, ADAM C (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:C
Last Name:DEVANEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 W 3RD ST UNIT E - 524
Mailing Address - Street 2:
Mailing Address - City:KALKASKA
Mailing Address - State:MI
Mailing Address - Zip Code:49646-0524
Mailing Address - Country:US
Mailing Address - Phone:231-649-8003
Mailing Address - Fax:231-715-3222
Practice Address - Street 1:103 W 3RD ST. UNIT E - 524
Practice Address - Street 2:
Practice Address - City:KALKASKA
Practice Address - State:MI
Practice Address - Zip Code:49646-0524
Practice Address - Country:US
Practice Address - Phone:231-620-7977
Practice Address - Fax:231-715-3222
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-27
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010984771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical