Provider Demographics
NPI:1083703102
Name:ADAMS, JOAN MICHELE (MSW)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:MICHELE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:769 SAINT NICHOLAS AVE
Mailing Address - Street 2:APT. 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-3933
Mailing Address - Country:US
Mailing Address - Phone:212-368-6890
Mailing Address - Fax:
Practice Address - Street 1:386 PARK AVE S
Practice Address - Street 2:STE 401
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8804
Practice Address - Country:US
Practice Address - Phone:212-481-2500
Practice Address - Fax:212-481-8157
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0068631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical