Provider Demographics
NPI:1457973380
Name:ADAMS, ANITA J (LMFT)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:J
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5218 CORNELIUS AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-2512
Mailing Address - Country:US
Mailing Address - Phone:317-313-6280
Mailing Address - Fax:
Practice Address - Street 1:5218 CORNELIUS AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-2512
Practice Address - Country:US
Practice Address - Phone:317-313-6280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001887A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health