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NPI Code Detail

MEDICARE: MR. EUGENE ARTHUR CLERVI II MSW,LCSW

MEDICARE: MR. EUGENE ARTHUR CLERVI II MSW,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
11041C0700XClinical Social Worker001407MO

General Provider Information

NPI Number : 1659355444
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EUGENE ARTHUR CLERVI II MSW,LCSW
Provider Business Mailing Address
First Line : 1600 ROSEBUD CT
Second Line :
City : MEXICO
State : MO
Zip : 65265-1461
Country : US
Telephone Number : 573-581-5023
Fax Number :
Provider Business Practice Location Address
First Line : 620 E MONROE ST
Second Line :
City : MEXICO
State : MO
Zip : 65265-2919
Country : US
Telephone Number : 573-582-8383
Fax Number : 573-582-3706
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2005
Last Update Date : 07/08/2007

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