Provider Demographics
NPI:1245812627
Name:ADAMS, CARLA (LPC, NCC)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 EAGLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-1773
Mailing Address - Country:US
Mailing Address - Phone:309-397-2896
Mailing Address - Fax:
Practice Address - Street 1:1905 EAGLE RIDGE DR
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-1773
Practice Address - Country:US
Practice Address - Phone:309-397-2896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-25
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013136101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty