Individual provider · Type 1 NPI

Kimberly Ann Pennock, LCSW

Clinical Social Worker · Waterloo, IL

NPI number 1073659504 Active

Practice location

988 N Illinois Route 3
Waterloo, IL 62298-1000

Call (618) 939-4444 Map

Fax (618) 939-4181

Mailing address

101 Lucys Lndg
Waterloo, IL 62298-5510

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XNone listed

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1073659504

Kimberly Ann Pennock, LCSW's National Provider Identifier is 1073659504, issued on Jan 30, 2007. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Waterloo, IL. The record was last updated on Jul 8, 2007.