Shauna Clark Gilbert, LCSW

Individual provider Active NPI Clinical Social Worker · Lake Saint Louis, MO

NPI 1164571006 · NPPES record last updated Feb 4, 2013

Key facts

NPI
1164571006
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
2012010106 (MO)
Practice address
1000 Lake Saint Louis Blvd
Suite 222
Lake Saint Louis, MO 63367-1340
Phone
(636) 265-1004
Fax
(636) 265-1005
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2012010106MOMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4552 LA
Clinical Social Worker 1041C0700X 2012010106 MO Yes

Addresses

Primary practice location

1000 Lake Saint Louis Blvd
Suite 222
Lake Saint Louis, MO 63367-1340

Mailing address

1000 Lake Saint Louis Blvd
Suite 222
Lake Saint Louis, MO 63367-1340
Phone (636) 265-1004

Other providers in Lake Saint Louis, MO

All providers in Lake Saint Louis, MO · Clinical Social Worker in Missouri

Sources for this page

Verify at the official NPI Registry.