Provider Demographics
NPI:1437488996
Name:ADAM, SIGNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SIGNE
Middle Name:
Last Name:ADAM
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 1:289 CHAPLIN RD
Mailing Address - Street 2:
Mailing Address - City:EASTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06242-9442
Mailing Address - Country:US
Mailing Address - Phone:860-974-0036
Mailing Address - Fax:860-974-0036
Practice Address - Street 1:289 CHAPLIN RD
Practice Address - Street 2:
Practice Address - City:EASTFORD
Practice Address - State:CT
Practice Address - Zip Code:06242-9442
Practice Address - Country:US
Practice Address - Phone:860-974-0036
Practice Address - Fax:860-974-0036
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-12
Last Update Date:2009-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0070761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT007076OtherSTATE OF CT DEPT OF PUBLIC HEALTH