Provider Demographics
NPI:1114685963
Name:ADAMS, NATASIA J (PHD, MPH)
Entity Type:Individual
Prefix:DR
First Name:NATASIA
Middle Name:J
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PHD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 N STAR DR APT 203
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718-3011
Mailing Address - Country:US
Mailing Address - Phone:334-590-9596
Mailing Address - Fax:
Practice Address - Street 1:1 SCIENCE CT
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-1055
Practice Address - Country:US
Practice Address - Phone:608-280-7084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4004-57103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical