Healthcare Provider Details

I. General information

NPI: 1174576326
Provider Name (Legal Business Name): STEVA D KAIL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 W PALMETTO PARK RD SUITE 205A
BOCA RATON FL
33433-3458
US

IV. Provider business mailing address

8435 BOCA RIO DR
BOCA RATON FL
33433-8325
US

V. Phone/Fax

Practice location:
  • Phone: 561-416-4999
  • Fax:
Mailing address:
  • Phone: 561-883-0671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0004440
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: