Provider Demographics
NPI:1326387796
Name:ADAMS, SHEVONE TASHA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:SHEVONE
Middle Name:TASHA
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36-36 33RD STREET
Mailing Address - Street 2:SUITE 502
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106
Mailing Address - Country:US
Mailing Address - Phone:718-426-8110
Mailing Address - Fax:718-426-8117
Practice Address - Street 1:36-36 33RD STREET
Practice Address - Street 2:SUITE 502
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106
Practice Address - Country:US
Practice Address - Phone:718-426-8110
Practice Address - Fax:718-426-8117
Is Sole Proprietor?:No
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0878251104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker