Provider Demographics
NPI:1407251606
Name:ADAMS, BRETTINA L (LCSW)
Entity Type:Individual
Prefix:
First Name:BRETTINA
Middle Name:L
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4821 US HIGHWAY 19 STE 4
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-4259
Mailing Address - Country:US
Mailing Address - Phone:727-807-7073
Mailing Address - Fax:
Practice Address - Street 1:4821 US HIGHWAY 19 STE 4
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4259
Practice Address - Country:US
Practice Address - Phone:727-807-7073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW146391041C0700X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No174400000XOther Service ProvidersSpecialist