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NPI Code Detail

MEDICARE: MR. DANIEL OWEN KEARLEY LCSW

MEDICARE: MR. DANIEL OWEN KEARLEY LCSW
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
11041C0700XClinical Social WorkerS14147TX
2101YA0400XAddiction (Substance Use Disorder) CounselorS14147TX

General Provider Information

NPI Number : 1356445951
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DANIEL OWEN KEARLEY LCSW
Provider Business Mailing Address
First Line : 1433 FAIRFIELD DR
Second Line :
City : AUSTIN
State : TX
Zip : 78758-7244
Country : US
Telephone Number : 512-491-8444
Fax Number : 512-491-0226
Provider Business Practice Location Address
First Line : 1433 FAIRFIELD DR
Second Line :
City : AUSTIN
State : TX
Zip : 78758-7244
Country : US
Telephone Number : 512-491-8444
Fax Number : 512-491-0226
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2006
Last Update Date : 12/12/2007

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