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NPI Code Detail

MEDICARE: MR. EDWARD P DEVANEY LCSWR

MEDICARE: MR. EDWARD P DEVANEY LCSWR
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 Worker

General Provider Information

NPI Number : 1558428169
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDWARD P DEVANEY LCSWR
Provider Business Mailing Address
First Line : 2814 SOUTH U.S. HWY 1 SUITE D4
Second Line :
City : FORT PIERCE
State : FL
Zip : 34982-0273
Country : US
Telephone Number : 772-489-4726
Fax Number :
Provider Business Practice Location Address
First Line : 2814 S US HIGHWAY 1 STE D4
Second Line :
City : FORT PIERCE
State : FL
Zip : 34982-8110
Country : US
Telephone Number : 772-489-4726
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2007
Last Update Date : 04/18/2017

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Directions to “ MR. EDWARD P DEVANEY LCSWR” Practice Location

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