Provider Demographics
NPI:1932231891
Name:ADAMS, PANSY DANIELS (LCMHCS, LCAS, CCS)
Entity Type:Individual
Prefix:MRS
First Name:PANSY
Middle Name:DANIELS
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LCMHCS, LCAS, CCS
Other - Prefix:MS
Other - First Name:PANSY
Other - Middle Name:
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMHCS, LCAS, CCS
Mailing Address - Street 1:3802 ROBERT PORCHER WAY
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2190
Mailing Address - Country:US
Mailing Address - Phone:336-389-6072
Mailing Address - Fax:336-389-6126
Practice Address - Street 1:3802 ROBERT PORCHER WAY
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2190
Practice Address - Country:US
Practice Address - Phone:336-389-6072
Practice Address - Fax:336-389-6126
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-1691101YA0400X
NCS10914101YM0800X
NCCCS-467101YA0400X
NC10914101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10914OtherLICENSED PROFESSIONAL COUNSELOR
NC1932231891Medicaid
GA1518OtherCACII CERT ADD COUNS II
GALPC004663OtherLICENSED PROFESSIONAL COUNSELOR
NC1691OtherLICENSED CLINICIAL ADDICTION SPECIALIST
GAC-33801OtherCERT CLINICAL EVALUATOR
NC467OtherCERTIFIED CLINICAL SUPERVISOR
GA0690OtherCERT RISK RED PROG INSTRU
GA11841OtherSAP SUBSTANCE ABUSE PROF
GAT-34401OtherASAM LEVEL I TX PROVIDER