Individual
CHRISTOPHER RYAN MASSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
402 N MISSOURI ST, POTOSI, MO 63664-1750
(573) 210-4959
Mailing address
PO BOX 215, POTOSI, MO 63664-0215
(573) 210-4959
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2019005818
MO
1041C0700X
Clinical Social Worker
Primary
2021014789
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490075951
—
MO
Enumeration date
09/18/2019
Last updated
05/03/2021
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