Provider Demographics
NPI:1053454496
Name:ADAMS, RODERICK E (PHD)
Entity Type:Individual
Prefix:DR
First Name:RODERICK
Middle Name:E
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2631 DONAHUE FERRY RD
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-4433
Mailing Address - Country:US
Mailing Address - Phone:318-641-0800
Mailing Address - Fax:318-641-0866
Practice Address - Street 1:2631 DONAHUE FERRY RD
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-4433
Practice Address - Country:US
Practice Address - Phone:318-641-0800
Practice Address - Fax:318-641-0866
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA364103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical