Provider Demographics
NPI:1558339895
Name:MEERS, KYLER EVERETT (MSW LICSW)
Entity Type:Individual
Prefix:MR
First Name:KYLER
Middle Name:EVERETT
Last Name:MEERS
Suffix:
Gender:M
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29038 KEPLER CIR
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:MN
Mailing Address - Zip Code:56320-9620
Mailing Address - Country:US
Mailing Address - Phone:320-685-7158
Mailing Address - Fax:320-685-4510
Practice Address - Street 1:29038 KEPLER CIR
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:MN
Practice Address - Zip Code:56320-9620
Practice Address - Country:US
Practice Address - Phone:320-685-7158
Practice Address - Fax:320-685-4510
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN109952OtherHOME BASED MENTAL HEALTH
MN8G757MEOtherHOME BASED MENTAL HEALTH
MNHP26196OtherHOME BASED MENTAL HEALTH
MN6282442OtherHOME BASED MENTAL HEALTH
MN990991016222OtherHOME BASED MENTAL HEALTH