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Individual

MR. JOHN MICHAEL CHILDRESS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
BLANCHFIELD ARMY COMMUNITY HOSPITAL, 650 JOLE DRIVE, FORT CAMPBELL, KY 42223-5349
(270) 798-8727
(270) 956-0180
Mailing address
BLANCHFIELD ARMY COMMUNITY HOSPITAL, 650 JOLE DRIVE, FORT CAMPBELL, KY 42223-5349
(270) 798-8727
(270) 956-0180

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW015017
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
VAD001
UPIN
KY
Enumeration date
07/25/2007
Last updated
04/30/2025
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