Provider Demographics
NPI:1982667598
Name:ADAMS, CATHERINE CAMPBELL (LMSW)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:CAMPBELL
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6886 W VERMONTVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:VERMONTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49096-9546
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:909 ABBOT RD STE B
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-3168
Practice Address - Country:US
Practice Address - Phone:269-430-3122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801046118104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
0C36171123Medicare ID - Type Unspecified