Healthcare Provider Details

I. General information

NPI: 1215717780
Provider Name (Legal Business Name): BARBARA ADAMICH, LICENSED CLINICAL SOCIAL WORKER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2023
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 KNOLL LN STE D
MILL VALLEY CA
94941-2369
US

IV. Provider business mailing address

1005 NORTHGATE DR # 319
SAN RAFAEL CA
94903-2500
US

V. Phone/Fax

Practice location:
  • Phone: 415-673-3566
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: BARBARA ADAMICH
Title or Position: OWNER
Credential: LCSW
Phone: 415-673-3566