Provider Demographics
NPI:1972195022
Name:ADKINS, CLARA (PHD, LCPC)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:
Last Name:ADKINS
Suffix:
Gender:F
Credentials:PHD, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 LIGHT ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-1251
Mailing Address - Country:US
Mailing Address - Phone:202-695-2144
Mailing Address - Fax:
Practice Address - Street 1:414 LIGHT ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-1251
Practice Address - Country:US
Practice Address - Phone:202-695-2144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11186101YP2500X
MDLC12631101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional