Individual provider · Type 1 NPI

Ida Mae Suttmoller, MA LCSW CASAC

Clinical Social Worker · Versailles, MO

NPI number 1912133323 Active

Practice location

108 West Jasper
Versailles, MO 65084

Fax (573) 378-6823

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X868 (MO)
Clinical Social Worker Primary 1041C0700X003970 (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 1912133323

Ida Mae Suttmoller, MA LCSW CASAC's National Provider Identifier is 1912133323, issued on Jun 1, 2009. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Versailles, MO. The record was last updated on Jun 1, 2009.