Charolette Loraine Adams, LSCSW

Individual provider Active NPI Clinical Social Worker · Leavenworth, KS

NPI 1003396003 · NPPES record last updated Aug 19, 2018

Key facts

NPI
1003396003
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
4364 (KS)
Practice address
111 Shawnee St Apt 607
Leavenworth, KS 66048-2071
Phone
(913) 240-1806
NPI assigned
Aug 19, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
4364KSMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4364 KS Yes

Addresses

Primary practice location

111 Shawnee St Apt 607
Leavenworth, KS 66048-2071

Mailing address

111 Shawnee St Apt 607
Leavenworth, KS 66048-2071
Phone (913) 240-1806

Other providers in Leavenworth, KS

All providers in Leavenworth, KS · Clinical Social Worker in Kansas

Sources for this page

Verify at the official NPI Registry.