MEDICARE: CAITLIN ADCOCK MA, RMHCI

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	101YM0800X	Mental Health Counselor	IMH25396	FL

General Provider Information

NPI Number	:	1265235006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLIN ADCOCK MA, RMHCI

Provider Business Mailing Address
First Line	:	11601 4TH ST N APT 2005
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33716-2743
Country	:	US
Telephone Number	:	352-789-0088
Fax Number	:

Provider Business Practice Location Address
First Line	:	730 S STERLING AVE STE 301
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4524
Country	:	US
Telephone Number	:	813-321-8280
Fax Number	:

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

Provider Enumeration Date	:	03/28/2025
Last Update Date	:	03/28/2025

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