MEDICARE: JOHN STEPHEN KIRBY LCSW

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
1	1041C0700X	Clinical Social Worker	CW026168	PA

General Provider Information

NPI Number	:	1255003166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN STEPHEN KIRBY LCSW

Provider Business Mailing Address
First Line	:	160 ROOSEVELT AVE
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17401-3378
Country	:	US
Telephone Number	:	717-845-2425
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 ROOSEVELT AVE
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17401-3378
Country	:	US
Telephone Number	:	717-845-2425
Fax Number	:	717-845-2425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2021
Last Update Date	:	03/19/2026

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