Individual
CHESTER A CAROTHERS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
10314 LINCOLN TRL STE 106, FAIRVIEW HEIGHTS, IL 62208-1801
(618) 875-9355
(630) 425-8900
Mailing address
PO BOX 6152, EAST SAINT LOUIS, IL 62202-6152
(618) 875-9355
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.017330
IL
Other
Enumeration date
08/19/2015
Last updated
08/25/2020
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