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Individual

MR. JOHN RICHARD DECARLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW-C

Contact information

Practice address
10411 W 145TH TER, OVERLAND PARK, KS 66221-2550
(913) 499-8096
Mailing address
10411 W 145TH TER, OVERLAND PARK, KS 66221-2550
(913) 499-8096

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
13115
MD
1041C0700X
Clinical Social Worker
Primary
2010038259
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1710172457
MD
05
1710172457
MO
Enumeration date
09/06/2007
Last updated
03/01/2011
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