Basic Information
Provider Information | |||||||||
NPI: | 1316031321 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ADAMS | ||||||||
FirstName: | SHEILA | ||||||||
MiddleName: | R | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | SOCIAL WORKER | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | ADAMS | ||||||||
OtherFirstName: | SHEILA | ||||||||
OtherMiddleName: | R | ||||||||
OtherNamePrefix: | DR. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | SOCIAL WORKER | ||||||||
OtherLastNameType: | 5 | ||||||||
Mailing Information | |||||||||
Address1: | 2817 REILLY ROAD | ||||||||
Address2: | MCXC-COD CREDENTIALS WOMACK ARMY MEDICAL CENTER | ||||||||
City: | FORT BRAGG | ||||||||
State: | NC | ||||||||
PostalCode: | 28310 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9109078922 | ||||||||
FaxNumber: | 9109076069 | ||||||||
Practice Location | |||||||||
Address1: | 2817 REILLY ROAD | ||||||||
Address2: | MCXC-COD CREDENTIALS WOMACK ARMY MEDICAL CENTER | ||||||||
City: | FORT BRAGG | ||||||||
State: | NC | ||||||||
PostalCode: | 28310 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9109078922 | ||||||||
FaxNumber: | 9109076069 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 10/03/2006 | ||||||||
LastUpdateDate: | 07/08/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 27907 |   | X |   | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 2022804 | MA | X |   | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.