Healthcare Provider Details

I. General information

NPI: 1689773335
Provider Name (Legal Business Name): ADELMAN & ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 W JASPER ST
VERSAILLES MO
65084-1020
US

IV. Provider business mailing address

PO BOX 21
VERSAILLES MO
65084-0021
US

V. Phone/Fax

Practice location:
  • Phone: 573-378-6833
  • Fax: 573-378-6823
Mailing address:
  • Phone: 573-378-6833
  • Fax: 573-378-6823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberR0513
License Number StateMO

VIII. Authorized Official

Name: STEVEN J ADELMAN
Title or Position: PRESIDENT
Credential: PSY D
Phone: 573-378-6833