Provider Demographics
NPI:1730245820
Name:ADAMS, THOMAS I (LISW)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:ADAMS
Suffix:I
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4697 LANDCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-4571
Mailing Address - Country:US
Mailing Address - Phone:216-571-1307
Mailing Address - Fax:
Practice Address - Street 1:11565 PEARL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-3356
Practice Address - Country:US
Practice Address - Phone:440-846-0862
Practice Address - Fax:440-846-0890
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-31
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-46461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical