MEDICARE: MICHAEL M THEVAR

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1548414998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL M THEVAR

Provider Business Mailing Address
First Line	:	PO BOX 454
Second Line	:
City	:	MONTGOMERYVILLE
State	:	PA
Zip	:	18936-0454
Country	:	US
Telephone Number	:	215-997-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	6930 MARKET ST FL 2
Second Line	:
City	:	UPPER DARBY
State	:	PA
Zip	:	19082-2308
Country	:	US
Telephone Number	:	215-997-2000
Fax Number	:

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

Provider Enumeration Date	:	11/12/2008
Last Update Date	:	11/21/2025

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Directions to “ MICHAEL M THEVAR ” Practice Location

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