Provider Demographics
NPI:1619059359
Name:ADELMAN, ROBERT ODINTZ (MSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ODINTZ
Last Name:ADELMAN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 S SHARON AMITY RD STE A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-2875
Mailing Address - Country:US
Mailing Address - Phone:704-364-0452
Mailing Address - Fax:704-364-5481
Practice Address - Street 1:417 S SHARON AMITY RD STE A
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-2875
Practice Address - Country:US
Practice Address - Phone:704-364-0452
Practice Address - Fax:704-364-5481
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0039651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12962OtherBC/BS