Provider Demographics
NPI:1194914291
Name:ADAMS, MAUREEN S (MA)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:S
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-4566
Mailing Address - Country:US
Mailing Address - Phone:910-738-8558
Mailing Address - Fax:910-738-8515
Practice Address - Street 1:202 W 15TH ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-4566
Practice Address - Country:US
Practice Address - Phone:910-738-8558
Practice Address - Fax:910-738-8515
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6525101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103778Medicaid