Provider Demographics
NPI:1255734406
Name:ADAMS, ANGELA MARIE I (MA, LPCC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:ADAMS
Suffix:I
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 W SUPERIOR ST STE 911
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-1717
Mailing Address - Country:US
Mailing Address - Phone:218-270-5055
Mailing Address - Fax:
Practice Address - Street 1:324 W SUPERIOR ST STE 911
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1717
Practice Address - Country:US
Practice Address - Phone:218-270-5055
Practice Address - Fax:218-216-8974
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-02
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN848101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional