Provider Demographics
NPI:1104194091
Name:ADAMS, MICHELLE L (LCSW, CADC, CODP I)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:L
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LCSW, CADC, CODP I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 1ST ST STE A
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:IL
Mailing Address - Zip Code:60417-2153
Mailing Address - Country:US
Mailing Address - Phone:708-420-3210
Mailing Address - Fax:
Practice Address - Street 1:8020 W 87TH ST
Practice Address - Street 2:
Practice Address - City:HICKORY HILLS
Practice Address - State:IL
Practice Address - Zip Code:60457-1189
Practice Address - Country:US
Practice Address - Phone:708-745-5277
Practice Address - Fax:708-741-4501
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2020-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL24994101YA0400X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)