Provider Demographics
NPI:1144580432
Name:HALVORSEN, ADAM D (MACP, LMHC, CDP, CPS)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:D
Last Name:HALVORSEN
Suffix:
Gender:M
Credentials:MACP, LMHC, CDP, CPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 SE CHKALOV DR STE 111NO111
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-5292
Mailing Address - Country:US
Mailing Address - Phone:360-844-0153
Mailing Address - Fax:
Practice Address - Street 1:1498 SE TECH CENTER PL STE 180
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-5518
Practice Address - Country:US
Practice Address - Phone:360-619-2226
Practice Address - Fax:360-326-9691
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO 60158865101YA0400X
PA78892083A0300X
WALH60930372101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine