Individual provider · Type 1 NPI

Kelly Rae Staddie, LCSW

Clinical Social Worker · Mexico, MO

NPI number 1093879835 Active

Practice location

734 W Monroe St
Mexico, MO 65265-1970

Fax (573) 642-5162

Mailing address

24 Lakeside Pl
Mexico, MO 65265-2227

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X2005008356 (MO)

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 1093879835

Kelly Rae Staddie, LCSW's National Provider Identifier is 1093879835, issued on Dec 19, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Mexico, MO. The record was last updated on Jul 8, 2007.