Provider Demographics
NPI:1972328128
Name:ADAMS, BRILLION (LCSW)
Entity type:Individual
Prefix:
First Name:BRILLION
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4603 S SHAMROCK RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-3110
Mailing Address - Country:US
Mailing Address - Phone:727-851-2090
Mailing Address - Fax:
Practice Address - Street 1:5005 W LAUREL ST STE 213
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-3836
Practice Address - Country:US
Practice Address - Phone:727-851-2090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW238701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical