Provider Demographics
NPI:1871635565
Name:ADAMS, FREDERICK QUINCY (MED)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:QUINCY
Last Name:ADAMS
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01108-1908
Mailing Address - Country:US
Mailing Address - Phone:413-746-4828
Mailing Address - Fax:
Practice Address - Street 1:235 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-1100
Practice Address - Country:US
Practice Address - Phone:413-734-4978
Practice Address - Fax:413-734-0467
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health