Provider Demographics
NPI:1396041307
Name:ADAMS, OZZIE DUDLEY II (CSAC)
Entity Type:Individual
Prefix:MR
First Name:OZZIE
Middle Name:DUDLEY
Last Name:ADAMS
Suffix:II
Gender:M
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1043
Mailing Address - Street 2:534 ADDOR RD.
Mailing Address - City:PINEBLUFF
Mailing Address - State:NC
Mailing Address - Zip Code:28373
Mailing Address - Country:US
Mailing Address - Phone:910-281-2071
Mailing Address - Fax:
Practice Address - Street 1:219 EAST STREET
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001
Practice Address - Country:US
Practice Address - Phone:704-983-8868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2656101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)