Provider Demographics
NPI:1679834378
Name:ADAMS, KELSI LYNN (LICSW)
Entity Type:Individual
Prefix:
First Name:KELSI
Middle Name:LYNN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3904 N ARDEN RD
Mailing Address - Street 2:
Mailing Address - City:OTIS ORCHARDS
Mailing Address - State:WA
Mailing Address - Zip Code:99027-9394
Mailing Address - Country:US
Mailing Address - Phone:509-280-7399
Mailing Address - Fax:
Practice Address - Street 1:7 S HOWARD ST
Practice Address - Street 2:321
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3821
Practice Address - Country:US
Practice Address - Phone:509-838-4128
Practice Address - Fax:509-838-4816
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW614519841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical