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General NPI Number Information
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NPI Number | 1346351392
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Entity Type | Individual
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Provider Name | DAVID ADAM KOERNER MSW, MPH
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/05/2020
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Provider Practice Location Address
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Address Line | 725 N 12TH AVE BLDG B
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City | ARCADIA
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State | FL
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Zip | 34266-8752
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Country | US
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Telephone | 863-494-1242
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Fax | 863-491-0466
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Provider Business Mailing Address
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Address Line | 15 DINGLE ST
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City | CHARLESTON
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State | SC
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Zip | 29403-4415
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Country | US
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Telephone | 843-789-7076
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 006508
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW15756
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License Number State | FL
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