Provider Demographics
NPI:1699028423
Name:BERKOWITZ, ADAM SPENCER (CASAC-G)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:SPENCER
Last Name:BERKOWITZ
Suffix:
Gender:M
Credentials:CASAC-G
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12182-0163
Mailing Address - Country:US
Mailing Address - Phone:518-881-7133
Mailing Address - Fax:
Practice Address - Street 1:55 MOHAWK ST
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-2600
Practice Address - Country:US
Practice Address - Phone:518-881-7133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22660101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)