Provider Demographics
NPI:1770534281
Name:ADAMS, JAMES EDWARD (CADC II)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:ADAMS
Suffix:
Gender:M
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6387 FOLEY LN
Mailing Address - Street 2:
Mailing Address - City:CENTRAL POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97502-9606
Mailing Address - Country:US
Mailing Address - Phone:541-951-2595
Mailing Address - Fax:541-830-3509
Practice Address - Street 1:8495 CRATER LAKE HWY
Practice Address - Street 2:VA SORCC - SATP 116C
Practice Address - City:WHITE CITY
Practice Address - State:OR
Practice Address - Zip Code:97503-3011
Practice Address - Country:US
Practice Address - Phone:541-826-2111
Practice Address - Fax:541-830-3509
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR97-R-14101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR97-R-14OtherCADC II