Provider Demographics
NPI:1134652076
Name:ADAMS, ROBERT DAVID NATHAN
Entity type:Individual
Prefix:
First Name:ROBERT DAVID
Middle Name:NATHAN
Last Name:ADAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 LINCOLN PARK BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-3479
Mailing Address - Country:US
Mailing Address - Phone:937-581-6929
Mailing Address - Fax:937-518-6097
Practice Address - Street 1:500 LINCOLN PARK BLVD STE 208
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-3479
Practice Address - Country:US
Practice Address - Phone:937-672-0674
Practice Address - Fax:937-518-6097
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2002008101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional