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Individual

CAROLINE PENBERTHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S.W., L.C.S.W.

Contact information

Practice address
12166 OLD BIG BEND RD, SUITE 100, KIRKWOOD, MO 63122-6844
(314) 909-0211
(314) 909-0323
Mailing address
12166 OLD BIG BEND RD, SUITE 100, KIRKWOOD, MO 63122-6844
(314) 909-0211
(314) 909-0323

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW000802
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
125668
BLUE CROSS BLUE SHIELD
MO
01
472758
HEALTHLINK
MO
01
6236004
UNITED BEHAVIORAL HEALTH
MO
01
O62230
EXCLUSIVE CHOICE
MO
01
R01055
MERCY HEALTH PLANS
MO
Enumeration date
11/03/2005
Last updated
07/09/2007
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