Provider Demographics
NPI:1336320571
Name:DICK, ADAM ROBERT
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:ROBERT
Last Name:DICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18217 HALE AVE
Mailing Address - Street 2:PSYNERGY PROGRAMS - MORGAN HILL
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-3550
Mailing Address - Country:US
Mailing Address - Phone:408-465-8280
Mailing Address - Fax:408-465-8281
Practice Address - Street 1:18217 HALE AVE
Practice Address - Street 2:PSYNERGY PROGRAMS - MORGAN HILL
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-3550
Practice Address - Country:US
Practice Address - Phone:408-465-8280
Practice Address - Fax:408-465-8281
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health