Individual
DR. CARISSA J VAN DEN BERK-CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LCSW
Contact information
Practice address
805 SAINT FRANCIS WAY, LITCHFIELD, IL 62056-1779
(217) 250-2380
Mailing address
1008 S SPRING AVE, SAINT LOUIS, MO 63110-2520
(314) 977-4840
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
150.103768
IL
1041C0700X
Clinical Social Worker
2022015061
MO
Other
Enumeration date
05/16/2024
Last updated
05/16/2024
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