Provider Demographics
NPI:1548492655
Name:GORMAN, ADAM (PSYD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:GORMAN
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 1:4 PALISADES DR STE 205
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1443
Mailing Address - Country:US
Mailing Address - Phone:518-434-1799
Mailing Address - Fax:518-434-1132
Practice Address - Street 1:4 PALISADES DR STE 205
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1443
Practice Address - Country:US
Practice Address - Phone:518-434-1799
Practice Address - Fax:518-434-1132
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-23
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021140103T00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist