Kevin Kiefaber

Individual provider Active NPI Clinical Social Worker · Rutland, VT

NPI 1285016162 · NPPES record last updated Jun 26, 2015

Key facts

NPI
1285016162
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
0890000502 (VT)
Practice address
78 S Main St
Rutland, VT 05701-4591
Phone
(802) 775-8224
Fax
(802) 747-7699
NPI assigned
Jun 26, 2015
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0890000502 VT Yes

Addresses

Primary practice location

78 S Main St
Rutland, VT 05701-4591

Mailing address

78 S Main St
Rutland, VT 05701-4591
Phone (802) 775-8224

Other providers in Rutland, VT

All providers in Rutland, VT · Clinical Social Worker in Vermont

Sources for this page

Verify at the official NPI Registry.