Provider Demographics
NPI:1407903511
Name:ADAMS, MARC WILLIAM (LCMHC)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:WILLIAM
Last Name:ADAMS
Suffix:
Gender:M
Credentials:LCMHC
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 232
Mailing Address - Street 2:
Mailing Address - City:HINESBURG
Mailing Address - State:VT
Mailing Address - Zip Code:05461-0232
Mailing Address - Country:US
Mailing Address - Phone:802-482-7267
Mailing Address - Fax:
Practice Address - Street 1:72 HARREL ST
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-8526
Practice Address - Country:US
Practice Address - Phone:802-888-5026
Practice Address - Fax:802-888-6393
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068-0000475101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT00049404OtherPROVIDER NUMBER
VT1007512Medicaid