Provider Demographics
NPI:1750470779
Name:ADAMS, LIA M (LPC)
Entity Type:Individual
Prefix:
First Name:LIA
Middle Name:M
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 N JULIAN ST
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-2614
Mailing Address - Country:US
Mailing Address - Phone:580-301-0940
Mailing Address - Fax:
Practice Address - Street 1:810 N JULIAN ST
Practice Address - Street 2:
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-2614
Practice Address - Country:US
Practice Address - Phone:580-301-0940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3018-LPC101YM0800X
TX18898-LPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health