Healthcare Provider Details
I. General information
NPI: 1285691543
Provider Name (Legal Business Name): RICHARD RYBERG ADAMS LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/28/2006
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
UNIT 33100 BOX LANDSTUHL
APO AE
09180-3100
US
IV. Provider business mailing address
CMR 427 BOX 3175
APO AE
09630-1032
US
V. Phone/Fax
- Phone: 314-636-9726
- Fax:
- Phone: 314-636-9726
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | 139832-3501 |
| License Number State | UT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 139832-3501 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: