Provider Demographics
NPI:1861129785
Name:ADAMS, JENAE ANNETTE (LMSW)
Entity type:Individual
Prefix:
First Name:JENAE
Middle Name:ANNETTE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7408 LAHRING RD
Mailing Address - Street 2:
Mailing Address - City:GAINES
Mailing Address - State:MI
Mailing Address - Zip Code:48436-9600
Mailing Address - Country:US
Mailing Address - Phone:517-294-5010
Mailing Address - Fax:
Practice Address - Street 1:1040 W BRISTOL RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-5516
Practice Address - Country:US
Practice Address - Phone:810-285-3312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010867321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical