Provider Demographics
NPI:1861186934
Name:MCADAMS, LUCINDA KATHLEEN
Entity type:Individual
Prefix:
First Name:LUCINDA
Middle Name:KATHLEEN
Last Name:MCADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 YACHT CLUB RD
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:MD
Mailing Address - Zip Code:21822-2263
Mailing Address - Country:US
Mailing Address - Phone:843-860-0003
Mailing Address - Fax:
Practice Address - Street 1:3510 YACHT CLUB RD
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:MD
Practice Address - Zip Code:21822-2263
Practice Address - Country:US
Practice Address - Phone:843-860-0003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1030442122255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer