Provider Demographics
NPI:1053981175
Name:CHAVIS, ADAM CRAWFORD (LGSW)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:CRAWFORD
Last Name:CHAVIS
Suffix:
Gender:M
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 WISCONSIN AVE NW APT 718
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-4522
Mailing Address - Country:US
Mailing Address - Phone:910-476-1657
Mailing Address - Fax:
Practice Address - Street 1:651 PENNSYLVANIA AVE SE STE 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-6302
Practice Address - Country:US
Practice Address - Phone:910-476-1657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG500837521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical