Provider Demographics
NPI:1497401749
Name:ADAMS, JIMMIETTA (LMSW)
Entity Type:Individual
Prefix:
First Name:JIMMIETTA
Middle Name:
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 1:6616 RONALD RD APT T1
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-7430
Mailing Address - Country:US
Mailing Address - Phone:202-415-7609
Mailing Address - Fax:
Practice Address - Street 1:6616 RONALD RD APT T1
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-7430
Practice Address - Country:US
Practice Address - Phone:202-415-7609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28066104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker