Provider Demographics
NPI:1437658168
Name:ADAMS, ROBERT J
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:ADAMS
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 1:671 EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-3414
Mailing Address - Country:US
Mailing Address - Phone:315-789-2613
Mailing Address - Fax:315-789-2524
Practice Address - Street 1:6539 ANTHONY DR STE A
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-1441
Practice Address - Country:US
Practice Address - Phone:585-398-8835
Practice Address - Fax:585-398-7376
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2024-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY011447101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health