Healthcare Provider Details

I. General information

NPI: 1912496951
Provider Name (Legal Business Name): BARBARA ADCOCK LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2018
Last Update Date: 05/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 GRAHAM DR
ATHENS OH
45701-1430
US

IV. Provider business mailing address

PO BOX 1595
COLUMBUS OH
43216-1595
US

V. Phone/Fax

Practice location:
  • Phone: 800-321-8293
  • Fax: 740-594-9967
Mailing address:
  • Phone: 800-321-8293
  • Fax: 740-594-9967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.1200309
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: