Provider Demographics
NPI:1689176539
Name:ADAMS, ASHLEY S
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:S
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 1:17356 US HIGHWAY 301 N
Mailing Address - Street 2:
Mailing Address - City:STARKE
Mailing Address - State:FL
Mailing Address - Zip Code:32091-1619
Mailing Address - Country:US
Mailing Address - Phone:904-872-7150
Mailing Address - Fax:
Practice Address - Street 1:17356 US HIGHWAY 301 N
Practice Address - Street 2:
Practice Address - City:STARKE
Practice Address - State:FL
Practice Address - Zip Code:32091-1619
Practice Address - Country:US
Practice Address - Phone:904-872-7150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)