Provider Demographics
NPI:1174991244
Name:ADAMS, ASHLEE JAE (LCSW)
Entity type:Individual
Prefix:MISS
First Name:ASHLEE
Middle Name:JAE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7418 SE 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-8802
Mailing Address - Country:US
Mailing Address - Phone:303-718-0461
Mailing Address - Fax:303-617-2365
Practice Address - Street 1:7418 SE 27TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-8802
Practice Address - Country:US
Practice Address - Phone:303-718-0461
Practice Address - Fax:303-617-2365
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.009267551041C0700X
390200000X
ORL95191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program