Provider Demographics
NPI:1730637000
Name:COCCARO, ADAM JASON (LMSW)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:JASON
Last Name:COCCARO
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 JONES ST APT 14
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-5603
Mailing Address - Country:US
Mailing Address - Phone:646-234-5698
Mailing Address - Fax:212-399-5444
Practice Address - Street 1:500 8TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-6504
Practice Address - Country:US
Practice Address - Phone:212-679-4960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY098071101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health