Provider Demographics
NPI:1528457108
Name:ADAMS, ANGELA MICHELLE (PLPC)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:MICHELLE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 6TH ST
Mailing Address - Street 2:
Mailing Address - City:FISK
Mailing Address - State:MO
Mailing Address - Zip Code:63940-6122
Mailing Address - Country:US
Mailing Address - Phone:573-776-9060
Mailing Address - Fax:
Practice Address - Street 1:760 PLANTATION BLVD
Practice Address - Street 2:
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-5736
Practice Address - Country:US
Practice Address - Phone:573-421-0800
Practice Address - Fax:573-421-0810
Is Sole Proprietor?:No
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014039278101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional