Provider Demographics
NPI:1558739946
Name:ADAMS, WHITNEY W (LCSW, LADC, CCS)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:W
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LCSW, LADC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 DEERING AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-4858
Mailing Address - Country:US
Mailing Address - Phone:207-480-3491
Mailing Address - Fax:
Practice Address - Street 1:20 INKHORN BROOK RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-4091
Practice Address - Country:US
Practice Address - Phone:207-480-3491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-02
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC142461041C0700X
MELC15607101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical