Provider Demographics
NPI:1033287370
Name:ADAMCZYK, THOMAS STEPHAN (MSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:STEPHAN
Last Name:ADAMCZYK
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LYNNFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01940-2514
Mailing Address - Country:US
Mailing Address - Phone:781-334-2645
Mailing Address - Fax:781-334-5545
Practice Address - Street 1:180 MAIN STREET
Practice Address - Street 2:LYNNFIELD PSYCHOLOGICAL ASSOCIATES PC
Practice Address - City:LYNNFIELD
Practice Address - State:MA
Practice Address - Zip Code:01940-2514
Practice Address - Country:US
Practice Address - Phone:781-334-2644
Practice Address - Fax:781-334-5545
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1035561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP01183Medicare ID - Type Unspecified