Provider Demographics
NPI:1275170979
Name:ADAMS, SAMANTHA AMANDA (MA APC NCC)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:AMANDA
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MA APC NCC
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:RUMBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, APC, NCC
Mailing Address - Street 1:523 DIXIE ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-3870
Mailing Address - Country:US
Mailing Address - Phone:770-812-8245
Mailing Address - Fax:770-812-8814
Practice Address - Street 1:523 DIXIE ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-3870
Practice Address - Country:US
Practice Address - Phone:770-812-8245
Practice Address - Fax:770-812-8814
Is Sole Proprietor?:No
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC005965101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional