Individual
MRS. DARLA B WEXSTTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, ACSW
Contact information
Practice address
4230 LINCOLNSHIRE DR, SUITE E, MOUNT VERNON, IL 62864-2189
(618) 242-4205
(618) 242-4209
Mailing address
4230 LINCOLNSHIRE DR, SUITE E, MOUNT VERNON, IL 62864-2189
(618) 242-4205
(618) 242-4209
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AETNA 5424723
LCSW
IL
01
—
BC/BS 04132009
LCSW
IL
01
—
TRICARE
LCSW
IL
Enumeration date
09/06/2006
Last updated
07/08/2007
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