Provider Demographics
NPI:1831958628
Name:ADAMS, MESHAN R (APSW)
Entity type:Individual
Prefix:
First Name:MESHAN
Middle Name:R
Last Name:ADAMS
Suffix:
Gender:M
Credentials:APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 RED BIRCH RUN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718-3447
Mailing Address - Country:US
Mailing Address - Phone:608-513-4992
Mailing Address - Fax:
Practice Address - Street 1:26 SCHROEDER CT STE 210
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2503
Practice Address - Country:US
Practice Address - Phone:608-513-4992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI132613-1211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical