Individual
MAX J PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
U
Credential
LCSW
Contact information
Practice address
705 E LAHARPE ST STE C, KIRKSVILLE, MO 63501-4526
(660) 988-9669
(888) 414-6717
Mailing address
PO BOX 924, KIRKSVILLE, MO 63501-0924
(660) 988-9669
(888) 414-6717
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2020038772
MO
1041C0700X
Clinical Social Worker
Primary
2023001049
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490143641
—
MO
Enumeration date
01/14/2021
Last updated
01/20/2026
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