MEDICARE: MR. KYLER EVERETT MEERS MSW LICSW

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
1	1041C0700X	Clinical Social Worker	420	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	109952	OTHER	MN	HOME BASED MENTAL HEALTH
2	8G757ME	OTHER	MN	HOME BASED MENTAL HEALTH
3	HP26196	OTHER	MN	HOME BASED MENTAL HEALTH
4	6282442	OTHER	MN	HOME BASED MENTAL HEALTH
5	990991016222	OTHER	MN	HOME BASED MENTAL HEALTH

General Provider Information

NPI Number	:	1558339895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KYLER EVERETT MEERS MSW LICSW

Provider Business Mailing Address
First Line	:	29038 KEPLER CIR
Second Line	:
City	:	COLD SPRING
State	:	MN
Zip	:	56320-9620
Country	:	US
Telephone Number	:	320-685-7158
Fax Number	:	320-685-4510

Provider Business Practice Location Address
First Line	:	29038 KEPLER CIR
Second Line	:
City	:	COLD SPRING
State	:	MN
Zip	:	56320-9620
Country	:	US
Telephone Number	:	320-685-7158
Fax Number	:	320-685-4510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2006
Last Update Date	:	07/09/2007

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