Provider Demographics
NPI:1326146465
Name:ADAMS, NANCY LU (PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LU
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6541 KINGSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4227
Mailing Address - Country:US
Mailing Address - Phone:216-791-3800
Mailing Address - Fax:216-707-6401
Practice Address - Street 1:10701 EAST BLVD.
Practice Address - Street 2:.
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:216-707-6401
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3225103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
05149OtherBOARD CERTIFICATION