Provider Demographics
NPI:1992044135
Name:ADAMS, MARCIA KIPP (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:KIPP
Last Name:ADAMS
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-2823
Mailing Address - Country:US
Mailing Address - Phone:609-672-6668
Mailing Address - Fax:
Practice Address - Street 1:2688 MAIN ST RM 105
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-1701
Practice Address - Country:US
Practice Address - Phone:609-651-1244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0203241041C0700X
NJ44SC055214001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA097115OtherDDAP
NJ2000480OtherDMHAS-SUD
NJ896321004OtherDMHAS-MH
PA144400OtherDOH-MH