Individual provider · Type 1 NPI

Jerry Tabak, LCSW

Clinical Social Worker · O Fallon, MO

NPI number 1114276342 Active

Practice location

109 Church St, Suite 105
O Fallon, MO 63366-2894

Call (636) 294-0015 Map

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X002217 (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 1114276342

Jerry Tabak, LCSW's National Provider Identifier is 1114276342, issued on Sep 4, 2012. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in O Fallon, MO. The record was last updated on Sep 4, 2012.