Provider Demographics
NPI:1124190525
Name:VEVERKA, JAMES E (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:VEVERKA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:JIM
Other - Middle Name:E
Other - Last Name:VEVERKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2321 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLMAR
Mailing Address - State:PA
Mailing Address - Zip Code:18915
Mailing Address - Country:US
Mailing Address - Phone:215-997-3600
Mailing Address - Fax:215-997-9409
Practice Address - Street 1:2321 N BROAD ST
Practice Address - Street 2:
Practice Address - City:COLMAR
Practice Address - State:PA
Practice Address - Zip Code:18915
Practice Address - Country:US
Practice Address - Phone:215-997-3600
Practice Address - Fax:215-997-9409
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CW0132081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical