Provider Demographics
NPI:1174812408
Name:CATHERINE HUBBARD ADAMS, LLC
Entity type:Organization
Organization Name:CATHERINE HUBBARD ADAMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:HUBBARD
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:870-926-2170
Mailing Address - Street 1:1601 RAINBOW RD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8821
Mailing Address - Country:US
Mailing Address - Phone:479-254-1144
Mailing Address - Fax:479-254-1099
Practice Address - Street 1:1601 RAINBOW RD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8821
Practice Address - Country:US
Practice Address - Phone:479-254-1144
Practice Address - Fax:479-254-1099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR11-01P251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
12076677OtherCAQH