Provider Demographics
NPI:1841219235
Name:ADAMS, THERESA (LICSW)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:1960 N HOLY NAMES CT
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-5803
Mailing Address - Country:US
Mailing Address - Phone:509-242-2308
Mailing Address - Fax:
Practice Address - Street 1:1960 N HOLY NAMES CT
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-5803
Practice Address - Country:US
Practice Address - Phone:503-242-2308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL24231041C0700X
WALW000073891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical