Kelly J Myers, LCSW

Individual provider Active NPI Clinical Social Worker · Melbourne Beach, FL

NPI 1356830343 · NPPES record last updated May 4, 2018

Key facts

NPI
1356830343
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
SW15060 (FL)
Practice address
1706 Atlantic St Apt 3B
Melbourne Beach, FL 32951-2342
Phone
(321) 339-6757
NPI assigned
May 4, 2018
Sex
Female
Sole proprietor
Yes

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 SW15060 FL Yes

Addresses

Primary practice location

1706 Atlantic St Apt 3B
Melbourne Beach, FL 32951-2342

Mailing address

1706 Atlantic St Apt 3B
Melbourne Beach, FL 32951-2342
Phone (321) 339-6757

Other providers in Melbourne Beach, FL

All providers in Melbourne Beach, FL · Clinical Social Worker in Florida

Sources for this page

Verify at the official NPI Registry.