Provider Demographics
NPI:1457772634
Name:ADAME, ARMANDO (CADC-I CI4210415)
Entity Type:Individual
Prefix:
First Name:ARMANDO
Middle Name:
Last Name:ADAME
Suffix:
Gender:M
Credentials:CADC-I CI4210415
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-2302
Mailing Address - Country:US
Mailing Address - Phone:442-265-1525
Mailing Address - Fax:760-482-2983
Practice Address - Street 1:202 N 8TH ST
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-2302
Practice Address - Country:US
Practice Address - Phone:442-265-1525
Practice Address - Fax:760-482-2983
Is Sole Proprietor?:No
Enumeration Date:2013-12-14
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC0911214101YA0400X
CACI4210415101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)