# KEVIN DAVID MICHAEL MENASCO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1225475387
- **Gender:** Man
- **Credential:** L.C.S.W.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 1041C0700X | Clinical Social Worker | L9518 | OR | Yes |

## Other

- **Enumeration date:** 05/30/2013
- **Last updated:** 03/09/2022