MEDICARE: MRS. MELISSA SUE ADCOCK LCSW

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	104100000X	Social Worker	33005683A	IN
2	101YM0800X	Mental Health Counselor	CSW.09923913	CO
3	1041C0700X	Clinical Social Worker	SW24016	FL
4	1041C0700X	Clinical Social Worker	34006386A	IN
5	101YM0800X	Mental Health Counselor		FL

General Provider Information

NPI Number	:	1144599150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELISSA SUE ADCOCK LCSW

Provider Business Mailing Address
First Line	:	1464 IVER ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-3260
Country	:	US
Telephone Number	:	765-210-0220
Fax Number	:

Provider Business Practice Location Address
First Line	:	1464 IVER ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-3260
Country	:	US
Telephone Number	:	765-210-0220
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2011
Last Update Date	:	02/06/2026

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