Provider Demographics
NPI:1528205002
Name:ADAMS, MICHELE A (LISW-S)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:A
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LISW-S
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 57
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43301-0057
Mailing Address - Country:US
Mailing Address - Phone:740-382-5781
Mailing Address - Fax:740-223-0965
Practice Address - Street 1:940 MARION WILLIAMSPORT RD E
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-8684
Practice Address - Country:US
Practice Address - Phone:740-382-5781
Practice Address - Fax:740-223-0965
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.09000941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical