Provider Demographics
NPI:1528213675
Name:ADAMS, JENEVA D (MS)
Entity Type:Individual
Prefix:
First Name:JENEVA
Middle Name:D
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 LINCOLN WAY E
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46601-3220
Mailing Address - Country:US
Mailing Address - Phone:574-232-2255
Mailing Address - Fax:574-232-8968
Practice Address - Street 1:611 LINCOLN WAY E
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-3220
Practice Address - Country:US
Practice Address - Phone:574-232-2255
Practice Address - Fax:574-232-8968
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical