Provider Demographics
NPI:1255549408
Name:ADAMS, DENIS (MDIV, LCSW)
Entity type:Individual
Prefix:MR
First Name:DENIS
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:MDIV, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 S CANAL ST
Mailing Address - Street 2:APT. 9Q
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-3906
Mailing Address - Country:US
Mailing Address - Phone:312-382-0605
Mailing Address - Fax:
Practice Address - Street 1:130 S CANAL ST
Practice Address - Street 2:APT. 9Q
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-3906
Practice Address - Country:US
Practice Address - Phone:312-382-0605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical