Provider Demographics
NPI:1891722104
Name:ADAMS, MARYANN ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARYANN
Middle Name:ELIZABETH
Last Name:ADAMS
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 1:8127 ELBERON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-1812
Mailing Address - Country:US
Mailing Address - Phone:215-945-2550
Mailing Address - Fax:215-945-3595
Practice Address - Street 1:100 LEVITTOWN PKWY
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19054-3502
Practice Address - Country:US
Practice Address - Phone:215-945-2550
Practice Address - Fax:215-945-3595
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW002364L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0475447000OtherMHS FOR INDEPENDENCE BLUE
PA7091513OtherAETNA