Provider Demographics
NPI:1306114632
Name:ADAMS, SHAUNA (LISW)
Entity type:Individual
Prefix:MRS
First Name:SHAUNA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MISS
Other - First Name:SHAUNA
Other - Middle Name:
Other - Last Name:WILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25738 TARLTON ADELPHI RD
Mailing Address - Street 2:
Mailing Address - City:LAURELVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43135-9718
Mailing Address - Country:US
Mailing Address - Phone:740-656-2049
Mailing Address - Fax:
Practice Address - Street 1:100 NOE BIXBY RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1460
Practice Address - Country:US
Practice Address - Phone:614-892-2454
Practice Address - Fax:614-892-2459
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.11003981041C0700X
OHI.14400931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical