Provider Demographics
NPI:1215965140
Name:ADAMS MARTIN, ANGELA MARIE (MS, LCSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:ADAMS MARTIN
Suffix:
Gender:F
Credentials:MS, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2328 DALLAS CREEK LN
Mailing Address - Street 2:
Mailing Address - City:GREEN COVE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32043-8274
Mailing Address - Country:US
Mailing Address - Phone:217-898-8160
Mailing Address - Fax:
Practice Address - Street 1:2328 DALLAS CREEK LN
Practice Address - Street 2:
Practice Address - City:GREEN COVE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32043-8274
Practice Address - Country:US
Practice Address - Phone:217-898-8160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
FL143811041C0700X
IL1490098651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical