Provider Demographics
NPI:1275968018
Name:ADAMS, CHRISTIN NICHOLE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:CHRISTIN
Middle Name:NICHOLE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CHRISTIN
Other - Middle Name:
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:717 SAINT JOSEPH DR STE 156
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-2428
Mailing Address - Country:US
Mailing Address - Phone:269-759-9732
Mailing Address - Fax:
Practice Address - Street 1:1101 BROAD ST STE 165
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-1790
Practice Address - Country:US
Practice Address - Phone:269-759-9732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010937421041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty