Provider Demographics
NPI:1124500830
Name:MCADAMS, STACI (LCSW)
Entity type:Individual
Prefix:
First Name:STACI
Middle Name:
Last Name:MCADAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1649 TREETA TRL
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-9606
Mailing Address - Country:US
Mailing Address - Phone:512-667-8447
Mailing Address - Fax:
Practice Address - Street 1:1407 W STASSNEY LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-2947
Practice Address - Country:US
Practice Address - Phone:512-440-4812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX596891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical