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General NPI Number Information
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NPI Number | 1528576527
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Entity Type | Individual
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Provider Name | KEVIN R MYERS JR. MSW
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Gender | Male
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Dates
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Enumeration Date | 01/12/2018
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 807 LAWN AVE
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City | SELLERSVILLE
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State | PA
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Zip | 18960-1549
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Country | US
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Telephone | 215-257-6551
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Fax | 215-257-9347
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Provider Business Mailing Address
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Address Line | 807 LAWN AVE
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City | SELLERSVILLE
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State | PA
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Zip | 18960-1549
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Country | US
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Telephone | 215-257-6551
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Fax | 215-257-9347
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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 | CW021363
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License Number State | PA
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