Provider Demographics
NPI:1760732895
Name:ADAMS, MARIEL LINDSEY (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIEL
Middle Name:LINDSEY
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 IVY ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3907
Mailing Address - Country:US
Mailing Address - Phone:617-732-0252
Mailing Address - Fax:
Practice Address - Street 1:200 IVY ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-3907
Practice Address - Country:US
Practice Address - Phone:617-732-0252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
4989681041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool