Provider Demographics
NPI:1750128708
Name:ADAMS, ANTHONY J (CDCA)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:ADAMS
Suffix:
Gender:M
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 MORNINGSTAR DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307-2207
Mailing Address - Country:US
Mailing Address - Phone:330-942-4200
Mailing Address - Fax:
Practice Address - Street 1:928 MORNINGSTAR DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2207
Practice Address - Country:US
Practice Address - Phone:330-942-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.189009101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)