Provider Demographics
NPI:1952738114
Name:MCGEVERAN, JAMES (MSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MCGEVERAN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4403 DOUGLASTON PKWY
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1801
Mailing Address - Country:US
Mailing Address - Phone:646-387-9377
Mailing Address - Fax:
Practice Address - Street 1:4403 DOUGLASTON PKWY
Practice Address - Street 2:
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11363-1801
Practice Address - Country:US
Practice Address - Phone:646-387-9377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical