Provider Demographics
NPI:1619675840
Name:ADAMS, MAXINE HOPE
Entity Type:Individual
Prefix:
First Name:MAXINE
Middle Name:HOPE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 DORCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13219-1430
Mailing Address - Country:US
Mailing Address - Phone:315-278-8260
Mailing Address - Fax:
Practice Address - Street 1:2825 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-4066
Practice Address - Country:US
Practice Address - Phone:718-520-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health