Provider Demographics
NPI:1396071676
Name:KUMLER, KEARA E (LICSW)
Entity type:Individual
Prefix:MRS
First Name:KEARA
Middle Name:E
Last Name:KUMLER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 COMMONWEALTH AVE
Mailing Address - Street 2:APT. 19
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2750
Mailing Address - Country:US
Mailing Address - Phone:201-362-8278
Mailing Address - Fax:
Practice Address - Street 1:180 COMMONWEALTH AVE
Practice Address - Street 2:APARTMENT 19
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2750
Practice Address - Country:US
Practice Address - Phone:201-362-8278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-21
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053764001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical