Provider Demographics
NPI:1598811770
Name:ADKINS, CONSTANCE S (MS)
Entity Type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:S
Last Name:ADKINS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:14 ROSLYN RD
Mailing Address - Street 2:
Mailing Address - City:WABAN
Mailing Address - State:MA
Mailing Address - Zip Code:02468-1209
Mailing Address - Country:US
Mailing Address - Phone:617-332-5628
Mailing Address - Fax:617-965-6240
Practice Address - Street 1:53 LANGLEY RD
Practice Address - Street 2:STE 340
Practice Address - City:NEWTON CENTER
Practice Address - State:MA
Practice Address - Zip Code:02459-1919
Practice Address - Country:US
Practice Address - Phone:617-738-7668
Practice Address - Fax:617-965-6240
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1035581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AD P23525Medicare ID - Type Unspecified