Basic Information
| Provider Information | |||||||||
| NPI: | 1770527194 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCADAMS | ||||||||
| FirstName: | NADYNE | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | LPCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11 GRAHAM DR | ||||||||
| Address2: | P.O. BOX 132 | ||||||||
| City: | ATHENS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 457011430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405946807 | ||||||||
| FaxNumber: | 7405949967 | ||||||||
| Practice Location | |||||||||
| Address1: | 11 GRAHAM DR | ||||||||
| Address2: | |||||||||
| City: | ATHENS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 457011430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405946807 | ||||||||
| FaxNumber: | 7405949967 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2006 | ||||||||
| LastUpdateDate: | 11/20/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | E0003141 | OH | N | Behavioral Health & Social Service Providers | Counselor | 101YM0800X | E0003141 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YS0200X | E0003141 | OH | N | Behavioral Health & Social Service Providers | Counselor | School |
ID Information
| ID | Type | State | Issuer | Description | ANTHEM | 01 | OH | 000000208616 | OTHER |