Individual provider · Type 1 NPI
Mari Evonne Kong, LCSW
Clinical Social Worker · Rockford, IL
Practice location
5301 E State St Ste 101
Rockford, IL 61108-2388
Fax (815) 397-8588
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker Primary | 1041C0700X | 149.005213 (IL) |
| Clinical Social Worker | 1041C0700X | 1605-123 (WI) |
| Marriage & Family Therapist | 106H00000X | 612-124 (WI) |
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 1093044455
Mari Evonne Kong, LCSW's National Provider Identifier is 1093044455, issued on Dec 14, 2009. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Rockford, IL. The record was last updated on Dec 14, 2009.