Provider Demographics
NPI:1780709444
Name:WOODRUFF, ADAM SCOTT (MS)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:SCOTT
Last Name:WOODRUFF
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 MAIN ST
Mailing Address - Street 2:#221
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-5554
Mailing Address - Country:US
Mailing Address - Phone:303-774-9837
Mailing Address - Fax:303-774-7096
Practice Address - Street 1:380 MAIN ST
Practice Address - Street 2:#221
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-5554
Practice Address - Country:US
Practice Address - Phone:303-774-9837
Practice Address - Fax:303-774-7096
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1007106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist