1316034614 NPI number — ROBERT STEPHEN ADCOCK MSSW

Table of content: ROBERT STEPHEN ADCOCK MSSW (NPI 1316034614)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316034614 NPI number — ROBERT STEPHEN ADCOCK MSSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADCOCK
Provider First Name:
ROBERT
Provider Middle Name:
STEPHEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ADCOCK
Provider Other First Name:
ROBBY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1316034614
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 320331
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33679-2331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-335-5444
Provider Business Mailing Address Fax Number:
727-576-0651

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 S HOOVER BLVD
Provider Second Line Business Practice Location Address:
SUITE 170
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33609-3540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-335-5444
Provider Business Practice Location Address Fax Number:
727-576-0651
Provider Enumeration Date:
10/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  SW 5409 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: FL1429 . This is a "BRADMAN NETWORK" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 198686 . This is a "COMPSYCH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2074595 . This is a "CIGNA BEHAVIORAL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 7532382 . This is a "AETNA BEHAVIORAL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com