Provider Demographics
NPI:1215012455
Name:ADAMS, ANNE MARY (LADC)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARY
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SOUTH MAIN ST SUITE B
Mailing Address - Street 2:FIREHOUSE AT BARRE
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641
Mailing Address - Country:US
Mailing Address - Phone:802-479-0050
Mailing Address - Fax:802-479-0050
Practice Address - Street 1:8 SOUTH MAIN ST SUITE B
Practice Address - Street 2:FIREHOUSE AT BARRE
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641
Practice Address - Country:US
Practice Address - Phone:802-479-0050
Practice Address - Fax:802-479-0050
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000393101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT00069720OtherBLUE CROSS BLUE SHIELD
VT11688730OtherCAQH