Provider Demographics
NPI:1881840155
Name:ADAMS, DOREEN
Entity Type:Individual
Prefix:PROF
First Name:DOREEN
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DOREEN
Other - Middle Name:
Other - Last Name:CLIFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:67 BRIGHAM ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-2211
Mailing Address - Country:US
Mailing Address - Phone:808-664-7605
Mailing Address - Fax:
Practice Address - Street 1:866 KAAHUE ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1342
Practice Address - Country:US
Practice Address - Phone:808-664-7605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1672104100000X
HI36961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker