Provider Demographics
NPI:1518646405
Name:BURNFIN, ADAM E (CDCA II)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:E
Last Name:BURNFIN
Suffix:
Gender:M
Credentials:CDCA II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 N ENTERPRISE ST APT E
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-2545
Mailing Address - Country:US
Mailing Address - Phone:614-264-1733
Mailing Address - Fax:
Practice Address - Street 1:4352 W SYLVANIA AVE STE A
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3441
Practice Address - Country:US
Practice Address - Phone:419-561-5433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA186024101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty