Provider Demographics
NPI:1225014053
Name:GARNER, KEVIN EDWARD (LCSW)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:EDWARD
Last Name:GARNER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 YORK RIVER LN
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-4354
Mailing Address - Country:US
Mailing Address - Phone:757-881-9030
Mailing Address - Fax:
Practice Address - Street 1:515 STERNBERG AVE
Practice Address - Street 2:USA MEDDAC ASAP
Practice Address - City:FORT EUSTIS
Practice Address - State:VA
Practice Address - Zip Code:23604
Practice Address - Country:US
Practice Address - Phone:757-314-7551
Practice Address - Fax:757-314-7979
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040031701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical