Provider Demographics
NPI:1558502112
Name:PLOTNICK, ADAM BRIAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:BRIAN
Last Name:PLOTNICK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26105 ORCHARD LAKE RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-4576
Mailing Address - Country:US
Mailing Address - Phone:248-471-0071
Mailing Address - Fax:248-471-1995
Practice Address - Street 1:26105 ORCHARD LAKE RD
Practice Address - Street 2:SUITE 302
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-4576
Practice Address - Country:US
Practice Address - Phone:248-471-0071
Practice Address - Fax:248-471-1995
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008823103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical