Individual provider · Type 1 NPI
Dereik Lance Domerese, LCSW
Clinical Social Worker · Lees Summit, MO
Practice location
905 NE Rice Rd Ste B
Lees Summit, MO 64086-6300
Mailing address
2410 SW State Route 150
Lees Summit, MO 64082-2903
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker | 1041C0700X | 10198 (KS) |
| Clinical Social Worker Primary | 1041C0700X | 2016034259 (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 1760927586
Dereik Lance Domerese, LCSW's National Provider Identifier is 1760927586, issued on Jan 3, 2017. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Lees Summit, MO. The record was last updated on Jun 15, 2022.