Provider Demographics
NPI:1780152124
Name:ADAMS, ZACCAHEAUS (LCPC)
Entity type:Individual
Prefix:MR
First Name:ZACCAHEAUS
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6010 GRENFELL LOOP
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-5343
Mailing Address - Country:US
Mailing Address - Phone:704-930-6482
Mailing Address - Fax:
Practice Address - Street 1:11140 ROCKVILLE PIKE STE 602
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3184
Practice Address - Country:US
Practice Address - Phone:301-591-6830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-04
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10671101YP2500X
NCA14134101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional