Provider Demographics
NPI:1245421841
Name:ADAMS, CLEVERICK M (LMHC)
Entity Type:Individual
Prefix:
First Name:CLEVERICK
Middle Name:M
Last Name:ADAMS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7432 HIGHWAY 50
Mailing Address - Street 2:SUITE 109
Mailing Address - City:GROVELAND
Mailing Address - State:FL
Mailing Address - Zip Code:34736-9322
Mailing Address - Country:US
Mailing Address - Phone:407-470-2195
Mailing Address - Fax:407-445-9145
Practice Address - Street 1:7432 HIGHWAY 50
Practice Address - Street 2:SUITE 109
Practice Address - City:GROVELAND
Practice Address - State:FL
Practice Address - Zip Code:34736-9322
Practice Address - Country:US
Practice Address - Phone:407-470-2195
Practice Address - Fax:407-445-9145
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMAC-23612101YA0400X
FLMH8349101YM0800X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy