Provider Demographics
NPI:1891845327
Name:ADAMS, TIMOTHY S (LCSW)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:S
Last Name:ADAMS
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:PO BOX 110
Mailing Address - Street 2:
Mailing Address - City:CATSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12414-0110
Mailing Address - Country:US
Mailing Address - Phone:518-943-0244
Mailing Address - Fax:518-943-0934
Practice Address - Street 1:283 MAIN ST
Practice Address - Street 2:
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414-1512
Practice Address - Country:US
Practice Address - Phone:518-943-0244
Practice Address - Fax:518-943-0934
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0161481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN42671Medicare ID - Type Unspecified