Provider Demographics
NPI:1265123947
Name:ADCOCK, LORI A (BBA, CEAC, ATP)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:ADCOCK
Suffix:
Gender:F
Credentials:BBA, CEAC, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 BUCCANEER BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-7167
Mailing Address - Country:US
Mailing Address - Phone:571-287-0230
Mailing Address - Fax:
Practice Address - Street 1:77 BUCCANEER BLVD
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-7167
Practice Address - Country:US
Practice Address - Phone:571-287-0230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Practitioner
No171WH0202XOther Service ProvidersContractorHome Modifications
No225CA2500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Supplier