Provider Demographics
NPI:1265970545
Name:DUMAS, ADRIAN G (MA, LPC)
Entity type:Individual
Prefix:MISS
First Name:ADRIAN
Middle Name:G
Last Name:DUMAS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 88292
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49518-0292
Mailing Address - Country:US
Mailing Address - Phone:616-345-0394
Mailing Address - Fax:
Practice Address - Street 1:4346 NORMAN DR SE APT 102
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49508-8900
Practice Address - Country:US
Practice Address - Phone:616-345-0394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012309101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional