Provider Demographics
NPI:1821418179
Name:THARKUR, ADAM (MA LMHC MCAP ICADC)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:
Last Name:THARKUR
Suffix:
Gender:M
Credentials:MA LMHC MCAP ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 W SILVERTHORN LN
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32081-7001
Mailing Address - Country:US
Mailing Address - Phone:305-803-6029
Mailing Address - Fax:
Practice Address - Street 1:2233 PARK AVE
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-5570
Practice Address - Country:US
Practice Address - Phone:305-803-6029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-24
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health