Provider Demographics
NPI:1295083277
Name:IACARINO, ADAM LAWRENCE (LCPC)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:LAWRENCE
Last Name:IACARINO
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 BENFIELD BLVD
Mailing Address - Street 2:SUITE J
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-2639
Mailing Address - Country:US
Mailing Address - Phone:443-845-0012
Mailing Address - Fax:
Practice Address - Street 1:1110 BENFIELD BLVD
Practice Address - Street 2:SUITE J
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-2639
Practice Address - Country:US
Practice Address - Phone:443-845-0012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2019-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD5778101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional