Provider Demographics
NPI:1356409635
Name:BERKOWITZ, ADAM (LCSW, LISW-CP)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:
Last Name:BERKOWITZ
Suffix:
Gender:M
Credentials:LCSW, LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 ANNA KNAPP EXT
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-5412
Mailing Address - Country:US
Mailing Address - Phone:843-718-7912
Mailing Address - Fax:
Practice Address - Street 1:1001 ANNA KNAPP EXT
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5412
Practice Address - Country:US
Practice Address - Phone:843-718-7912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070514-11041C0700X
NCC0065761041C0700X
SC99671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical