Provider Demographics
NPI:1013506575
Name:ADAMS, MICHELLE (LCSW, LISW-CP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LCSW, LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 HASTINGS ST
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-3977
Mailing Address - Country:US
Mailing Address - Phone:904-710-3666
Mailing Address - Fax:
Practice Address - Street 1:3524 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:GRANITEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29829
Practice Address - Country:US
Practice Address - Phone:706-250-1442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0074361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical