Provider Demographics
NPI:1932608379
Name:BOJKO, ADAM T (MSW, LISW)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:T
Last Name:BOJKO
Suffix:
Gender:M
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 CARNEGIE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-2641
Mailing Address - Country:US
Mailing Address - Phone:440-260-8300
Mailing Address - Fax:440-234-8913
Practice Address - Street 1:7247 BIG CREEK PKWY
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-4816
Practice Address - Country:US
Practice Address - Phone:162-898-8303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-11
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.20022381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0282456Medicaid