Provider Demographics
NPI:1699366419
Name:ADAMS, TAMI ASHELY BRIDGETTE (MS, TLMHC)
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:ASHELY BRIDGETTE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MS, TLMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1522 B AVE NW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52405-3714
Mailing Address - Country:US
Mailing Address - Phone:319-210-7077
Mailing Address - Fax:
Practice Address - Street 1:3100 E AVE NW STE 105
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52405-2962
Practice Address - Country:US
Practice Address - Phone:800-531-4236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA107150101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health