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General NPI Number Information
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NPI Number | 1447478680
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Entity Type | Individual
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Provider Name | DEVIN MEARS LCSW
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Gender | Male
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12843 PENNRIDGE DR
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City | BRIDGETON
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State | MO
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Zip | 63044-1238
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Country | US
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Telephone | 314-344-0048
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Fax | 314-344-0057
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Provider Business Mailing Address
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Address Line | 512 DUCHESNE AVE
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City | O FALLON
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State | MO
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Zip | 63366-2763
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2002002940
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License Number State | MO
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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 |
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License Number State | IL
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