Provider Demographics
NPI:1871042416
Name:SCHOLL, ADAM JAMES (LCSW)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:JAMES
Last Name:SCHOLL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 N AURORA ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-4274
Mailing Address - Country:US
Mailing Address - Phone:607-342-4403
Mailing Address - Fax:
Practice Address - Street 1:318 N AURORA ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4274
Practice Address - Country:US
Practice Address - Phone:607-342-4403
Practice Address - Fax:607-391-0162
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-23
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076218-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health