Individual
MR. JOHN STEPHEN CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
590 W PACIFIC ST, BRANSON, MO 65616-2742
(417) 335-2080
(417) 336-3583
Mailing address
PO BOX 14517, SPRINGFIELD, MO 65814-0517
(417) 425-0065
(417) 335-8566
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW000939
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
496920307
—
MO
05
—
496920331
—
MO
Enumeration date
11/01/2006
Last updated
07/28/2022
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