Provider Demographics
NPI:1174837801
Name:SILVER STOCK, CARRIE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:SILVER STOCK
Suffix:
Gender:F
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 1:760 TIMBERVALLEY CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-1773
Mailing Address - Country:US
Mailing Address - Phone:314-374-5795
Mailing Address - Fax:636-794-3030
Practice Address - Street 1:1137 N MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-1498
Practice Address - Country:US
Practice Address - Phone:636-294-4640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050122651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical