Provider Demographics
NPI:1851578470
Name:HOOTEN, ADANA MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:ADANA
Middle Name:MARIE
Last Name:HOOTEN
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 1:208 FRANKSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-4146
Mailing Address - Country:US
Mailing Address - Phone:814-414-8105
Mailing Address - Fax:
Practice Address - Street 1:304 FRANKSTOWN RD
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602
Practice Address - Country:US
Practice Address - Phone:814-414-8105
Practice Address - Fax:814-943-2503
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW011532L101YM0800X
PACW017270101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007709460009Medicaid