Provider Demographics
NPI:1437428497
Name:DEVERS, EUGENE G (LCSW)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:G
Last Name:DEVERS
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 1:9343 KREWSTOWN RD # 92
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-3710
Mailing Address - Country:US
Mailing Address - Phone:215-554-8191
Mailing Address - Fax:
Practice Address - Street 1:1209 GRANT AVE
Practice Address - Street 2:2ND FL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-3706
Practice Address - Country:US
Practice Address - Phone:215-554-8191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2016-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0171551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical