Provider Demographics
NPI:1366903874
Name:VILMONT, ADAM F (LISW)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:F
Last Name:VILMONT
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 W 63RD ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52806-1647
Mailing Address - Country:US
Mailing Address - Phone:563-388-1039
Mailing Address - Fax:563-388-1014
Practice Address - Street 1:2711 W 63RD ST STE 3
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806-1647
Practice Address - Country:US
Practice Address - Phone:563-388-1039
Practice Address - Fax:563-388-1014
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0854011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical