Provider Demographics
NPI:1568074136
Name:ROBERTSON ADAMS, JALENA LOUISE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:JALENA
Middle Name:LOUISE
Last Name:ROBERTSON 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 1:2218 LYONS STATION RD
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:KY
Mailing Address - Zip Code:40051-8723
Mailing Address - Country:US
Mailing Address - Phone:502-827-2295
Mailing Address - Fax:
Practice Address - Street 1:2218 LYONS STATION RD
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:KY
Practice Address - Zip Code:40051-8723
Practice Address - Country:US
Practice Address - Phone:502-827-2295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2540581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical