Provider Demographics
NPI:1780273128
Name:ADAMS, IRA (BCBA, PHD)
Entity type:Individual
Prefix:
First Name:IRA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:BCBA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 E BELT LINE RD STE 107
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-5429
Mailing Address - Country:US
Mailing Address - Phone:214-789-1387
Mailing Address - Fax:469-453-3202
Practice Address - Street 1:2741 E BELT LINE RD STE 107
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-5429
Practice Address - Country:US
Practice Address - Phone:214-789-1387
Practice Address - Fax:469-453-3202
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1076103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst