Provider Demographics
NPI:1255038550
Name:LAWSON, ADAM KRISTOPHER
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:KRISTOPHER
Last Name:LAWSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5068 SHEFFIELD PLACE DR
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-7391
Mailing Address - Country:US
Mailing Address - Phone:423-329-1160
Mailing Address - Fax:
Practice Address - Street 1:380 KNOLLWOOD ST STE 505
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1884
Practice Address - Country:US
Practice Address - Phone:833-357-2966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0107631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical