Provider Demographics
NPI:1659630168
Name:ADAMS, TARA K (LCSW, RPT)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:K
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LCSW, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 KINGS HWY STE 302
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-7308
Mailing Address - Country:US
Mailing Address - Phone:302-450-3936
Mailing Address - Fax:302-450-3927
Practice Address - Street 1:144 KINGS HWY STE 302
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-7308
Practice Address - Country:US
Practice Address - Phone:302-450-3936
Practice Address - Fax:302-450-3927
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-04
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00011381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical