Provider Demographics
NPI:1932653243
Name:ADAMS, AMY N (LHSW)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:N
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LHSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22670 SUMMIT DRIVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601
Mailing Address - Country:US
Mailing Address - Phone:315-788-3332
Mailing Address - Fax:315-788-4584
Practice Address - Street 1:22670 SUMMIT DRIVE
Practice Address - Street 2:SUITE 2
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601
Practice Address - Country:US
Practice Address - Phone:315-788-3332
Practice Address - Fax:315-788-4584
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067235-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker