Provider Demographics
NPI:1316034614
Name:ADCOCK, ROBERT STEPHEN (MSSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:STEPHEN
Last Name:ADCOCK
Suffix:
Gender:M
Credentials:MSSW
Other - Prefix:
Other - First Name:ROBBY
Other - Middle Name:
Other - Last Name:ADCOCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 320331
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33679-2331
Mailing Address - Country:US
Mailing Address - Phone:813-335-5444
Mailing Address - Fax:727-576-0651
Practice Address - Street 1:200 S HOOVER BLVD
Practice Address - Street 2:SUITE 170
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3540
Practice Address - Country:US
Practice Address - Phone:813-335-5444
Practice Address - Fax:727-576-0651
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 54091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFL1429OtherBRADMAN NETWORK
FL198686OtherCOMPSYCH
FL2074595OtherCIGNA BEHAVIORAL
FL7532382OtherAETNA BEHAVIORAL
FL198686OtherCOMPSYCH