Jill Adams
Individual provider Active NPI Peer Specialist · Wooster, OH
NPI 1154865087 · NPPES record last updated Feb 27, 2020
Key facts
- NPI
- 1154865087
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- License
- 001284 (OH)
- Practice address
- 104 Spink St
Wooster, OH 44691-3652 - Phone
- (330) 264-8498
- NPI assigned
- Dec 12, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001284 | OH | MD | Peer Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Peer Specialist | 175T00000X | 001284 | OH | Yes |
Addresses
Primary practice location
104 Spink St
Wooster, OH 44691-3652
Mailing address
625 Cleveland Ave NW
Canton, OH 44702-1805
Phone (330) 453-8252
Other practice location 1
625 Cleveland Ave NW
Canton, OH 44702-1805
Phone (330) 453-8252 ext. 361
Other providers in Wooster, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.