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NPI Code Detail

MEDICARE: KEVIN M KILLARNEY M. ED.

MEDICARE: KEVIN M KILLARNEY M. ED.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1053676999
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN M KILLARNEY M. ED.
Provider Business Mailing Address
First Line : 78 PARTING ROCK RD
Second Line :
City : DUXBURY
State : MA
Zip : 02332-3214
Country : US
Telephone Number : 781-296-3878
Fax Number :
Provider Business Practice Location Address
First Line : 61 INDUSTRIAL PARK RD
Second Line :
City : PLYMOUTH
State : MA
Zip : 02360-7246
Country : US
Telephone Number : 508-503-5020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2012
Last Update Date : 11/17/2021

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Directions to “ KEVIN M KILLARNEY M. ED.” Practice Location

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