Provider Demographics
NPI:1326248675
Name:ADAMS, CONSTANCE RENEE
Entity Type:Individual
Prefix:DR
First Name:CONSTANCE
Middle Name:RENEE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 61237
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27661-1237
Mailing Address - Country:US
Mailing Address - Phone:843-492-4944
Mailing Address - Fax:888-552-1363
Practice Address - Street 1:5620 AMES AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-2754
Practice Address - Country:US
Practice Address - Phone:402-453-5388
Practice Address - Fax:402-451-3893
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2017-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3054101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health