Provider Demographics
NPI:1851676654
Name:KIEVAL, NATHANIEL EZRA (LMHC, MS,ED)
Entity type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:EZRA
Last Name:KIEVAL
Suffix:
Gender:M
Credentials:LMHC, MS,ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1805
Mailing Address - Country:US
Mailing Address - Phone:781-369-5644
Mailing Address - Fax:
Practice Address - Street 1:37 CLARK ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1805
Practice Address - Country:US
Practice Address - Phone:781-369-5644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health