Provider Demographics
NPI:1093732422
Name:FLENNER, GEORGE (MSW LCSW)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:FLENNER
Suffix:
Gender:M
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5203 S COWAN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-9789
Mailing Address - Country:US
Mailing Address - Phone:573-449-7227
Mailing Address - Fax:573-499-0702
Practice Address - Street 1:3201 S PROVIDENCE RD
Practice Address - Street 2:STE 201
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-3622
Practice Address - Country:US
Practice Address - Phone:573-499-3875
Practice Address - Fax:573-499-0702
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLCSW 000512101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health