Provider Demographics
NPI:1194248245
Name:ADAMS, CLARISSA (LCSWA)
Entity type:Individual
Prefix:
First Name:CLARISSA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 JACKSON RD APT 2
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-8525
Mailing Address - Country:US
Mailing Address - Phone:828-557-6558
Mailing Address - Fax:
Practice Address - Street 1:120 CHADWICK SQUARE CT
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-3201
Practice Address - Country:US
Practice Address - Phone:828-697-4187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0118271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical