Provider Demographics
NPI:1174700470
Name:BRICKLER, ADAM (PSYD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:BRICKLER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7511 NEW LAGRANGE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4859
Mailing Address - Country:US
Mailing Address - Phone:502-423-1151
Mailing Address - Fax:502-423-1748
Practice Address - Street 1:7511 NEW LAGRANGE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-4859
Practice Address - Country:US
Practice Address - Phone:502-423-1151
Practice Address - Fax:502-423-1748
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2005-104103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist