| Dynamic Counseling And Consultation Services | |
|
3600 S Water Tower Pl Mt Vernon IL 62864 | |
| (314) 719-6263 | |
| (800) 335-4761 |
| Full Name | Dynamic Counseling And Consultation Services |
|---|---|
| Speciality | Social Worker |
| Location | 3600 S Water Tower Pl, Mt Vernon, Illinois |
| Authorized Official Name and Position | Carrie Crocker (OWNER) |
| Authorized Official Contact | 3147196263 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Counseling And Consultation Services 3600 S Water Tower Pl Mt Vernon IL 62864 Ph: (314) 719-6263 | Dynamic Counseling And Consultation Services 3600 S Water Tower Pl Mt Vernon IL 62864 Ph: (314) 719-6263 |
| NPI Number | 1457771677 |
|---|---|
| Provider Enumeration Date | 04/27/2014 |
| Last Update Date | 11/23/2015 |
| Medicare PECOS PAC ID | 6709186703 |
|---|---|
| Medicare Enrollment ID | O20151124000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457771677 | NPI | - | NPPES |
| 497312108 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2003032196 (Missouri) | Primary |
| Provider Name | Carrie C Crocker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972657187 PECOS PAC ID: 6002947017 Enrollment ID: I20151124000336 |
| Provider Name | Tiffany Nicole Shurtz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467112417 PECOS PAC ID: 6002200888 Enrollment ID: I20220221000700 |
Mt Vernon Community Health Center Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2920 Veterans Parkway, Mt Vernon, IL 62864 Phone: 618-244-6544 Fax: 618-244-6577 | |
Lutheran Child And Family Service Of Illinois Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 618 S. 42nd St, Mt Vernon, IL 62864 Phone: 618-242-3284 Fax: 618-242-3288 | |
Substance Abuse Outpatient Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 16338 N Il Hwy 37, Mt Vernon, IL 62864 Phone: 618-242-1994 Fax: 618-242-6392 | |
Jefferson County Comprehensive Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 16342 N Il Hwy 37, Mt Vernon, IL 62864 Phone: 618-242-1510 Fax: 618-242-0958 |