Individual
JERRY C CLERC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MED LPC
Contact information
Practice address
225 SO MERAMEC, ST 506, CLAYTON, MO 63105
(314) 863-3588
(314) 863-0074
Mailing address
3631 TAMM, ST LOUIS, MO 63109
(314) 863-3588
(314) 863-0074
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
000683
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ANTHEM 1111
BCBS ANTHEM NUMBER
MO
Enumeration date
12/12/2006
Last updated
07/08/2007
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