Individual
CHARLES R ADCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4906 RADFORD AVE, RICHMOND, VA 23230-3512
(804) 354-1996
(804) 354-5516
Mailing address
4906 RADFORD AVE, RICHMOND, VA 23230-3512
(804) 354-1996
(804) 354-5516
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0904002513
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1019476
CIGNA PROV #
VA
01
—
102045
VALUE OPTION PROV #
VA
01
—
145129
ANTHEM PROV #
VA
01
—
168467000
MAGELLAN MIS
VA
01
—
303526
ANTHEM
VA
01
—
5608429
AETNA PROV #
VA
01
—
84904
OPTIMA BEHAVIORAL HEALTH
VA
01
—
861112647
UBH
—
01
—
N06B91
EMPIRE PROV #
VA
Enumeration date
02/26/2007
Last updated
05/29/2008
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