Provider Demographics
NPI:1912136466
Name:ADAMS CENTER FOR COUNSELING LLC
Entity Type:Organization
Organization Name:ADAMS CENTER FOR COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:JYL
Authorized Official - Middle Name:E
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-484-3359
Mailing Address - Street 1:2525 N STOKESBERRY PL UNIT A
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-1510
Mailing Address - Country:US
Mailing Address - Phone:208-321-4166
Mailing Address - Fax:208-321-4167
Practice Address - Street 1:2525 N STOKESBERRY PL
Practice Address - Street 2:SUITE A
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-1502
Practice Address - Country:US
Practice Address - Phone:208-321-4166
Practice Address - Fax:208-321-4167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-06
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health