Provider Demographics
NPI:1235231713
Name:KIJANSKI, ADAM M (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:M
Last Name:KIJANSKI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 W NORTH A ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-2350
Mailing Address - Country:US
Mailing Address - Phone:813-876-5282
Mailing Address - Fax:813-673-8946
Practice Address - Street 1:3009 W NORTH A ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2350
Practice Address - Country:US
Practice Address - Phone:813-876-5282
Practice Address - Fax:813-673-8946
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW82681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical