Provider Demographics
NPI:1295812188
Name:SYVERTSEN, KAI PAUL (PHD)
Entity type:Individual
Prefix:DR
First Name:KAI
Middle Name:PAUL
Last Name:SYVERTSEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1218 CHESTNUT ST
Mailing Address - Street 2:SUITE 607
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107
Mailing Address - Country:US
Mailing Address - Phone:215-625-9655
Mailing Address - Fax:215-625-8524
Practice Address - Street 1:1218 CHESTNUT ST
Practice Address - Street 2:SUITE 607
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107
Practice Address - Country:US
Practice Address - Phone:215-625-9655
Practice Address - Fax:215-625-8524
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPS016238103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical