Organization
DYNAMIC COUNSELING AND CONSULTATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARRIE CROCKER LCSW (OWNER)
(618) 816-1224
Entity
Organization
Contact information
Practice address
4202 WILLIAMSON PL STE 1, MOUNT VERNON, IL 62864-6760
(618) 816-1224
(800) 335-4761
Mailing address
1111 S LINCOLN AVE UNIT 1326, O FALLON, IL 62269-5165
(618) 816-1224
(800) 335-4761
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2003032196
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497312108
—
MO
Enumeration date
04/27/2014
Last updated
01/27/2025
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