Healthcare Provider Details

I. General information

NPI: 1093500407
Provider Name (Legal Business Name): ADAM JOSEPH JADICK LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPARTMENT OF THE AIR FORCE 86 MDG OPC 02 BOX 60
APO AE
09094-9001
US

IV. Provider business mailing address

OPC 2 BOX 60
APO AE
09094-9001
US

V. Phone/Fax

Practice location:
  • Phone: 314-479-2390
  • Fax:
Mailing address:
  • Phone: 314-479-2390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06300100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: