Provider Demographics
NPI:1609978733
Name:DON, CAROL J (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:J
Last Name:DON
Suffix:
Gender:F
Credentials:LCSW
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Mailing Address - Street 1:7700 CLAYTON ROAD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117
Mailing Address - Country:US
Mailing Address - Phone:314-647-3558
Mailing Address - Fax:314-647-3605
Practice Address - Street 1:7700 CLAYTON ROAD
Practice Address - Street 2:SUITE 208
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117
Practice Address - Country:US
Practice Address - Phone:314-647-3558
Practice Address - Fax:314-647-3605
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001150LLSW1041C0700X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO058086OtherVALUE OPTIONS
MO113820OtherBCBS