Provider Demographics
NPI:1346053204
Name:ADAMS, JENNIFER (ADAMS)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:ADAMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 E 175TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-5859
Mailing Address - Country:US
Mailing Address - Phone:718-960-7522
Mailing Address - Fax:
Practice Address - Street 1:1006 EAST 151ST STREET, 1ST - 4TH FLOOR
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-1045
Practice Address - Country:US
Practice Address - Phone:718-960-7522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)