Provider Demographics
NPI:1518186238
Name:ADAMS, M MELISSA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:M
Middle Name:MELISSA
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 1:57 MISTLETOE CT
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-4163
Mailing Address - Country:US
Mailing Address - Phone:979-297-6008
Mailing Address - Fax:
Practice Address - Street 1:104 CIRCLE WAY ST
Practice Address - Street 2:SUITE E
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5200
Practice Address - Country:US
Practice Address - Phone:979-297-8565
Practice Address - Fax:979-299-6626
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX167381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical