MEDICARE: ADR CLINICAL ASSOCIATES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1003902685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADR CLINICAL ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	1309 JAMESTOWN RD
Second Line	:	STE. 101
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-3380
Country	:	US
Telephone Number	:	757-220-8800
Fax Number	:	757-220-8811

Provider Business Practice Location Address
First Line	:	1309 JAMESTOWN RD
Second Line	:	STE. 101
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-3380
Country	:	US
Telephone Number	:	757-220-8800
Fax Number	:	757-220-8811

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT ABDO
Credential	:	EDD
Telephone Number	:	757-220-8800

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	10/17/2011

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