Provider Demographics
NPI:1174833347
Name:ADAMS, KAREN SUZETTE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:SUZETTE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4143 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-4731
Mailing Address - Country:US
Mailing Address - Phone:602-274-3492
Mailing Address - Fax:
Practice Address - Street 1:4143 N 10TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-4731
Practice Address - Country:US
Practice Address - Phone:602-274-3492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-26771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLCSW-2677OtherLICENSED CLINICAL SOCIAL WORKER