Provider Demographics
NPI:1972030328
Name:NASH, ADAM (LPC)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:
Last Name:NASH
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1664 N M 37 HWY
Mailing Address - Street 2:
Mailing Address - City:MIDDLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49333-8489
Mailing Address - Country:US
Mailing Address - Phone:616-676-7081
Mailing Address - Fax:
Practice Address - Street 1:1664 N M 37 HWY
Practice Address - Street 2:
Practice Address - City:MIDDLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:49333-8489
Practice Address - Country:US
Practice Address - Phone:616-676-7081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-16
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015894101YP2500X
MI6401018358101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional