Provider Demographics
NPI:1316178114
Name:PRESLEY, THERESA ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:ANN
Last Name:PRESLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:ANN
Other - Last Name:CROMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 SHORT ST
Mailing Address - Street 2:
Mailing Address - City:KNOB NOSTER
Mailing Address - State:MO
Mailing Address - Zip Code:65336-1543
Mailing Address - Country:US
Mailing Address - Phone:660-563-1430
Mailing Address - Fax:
Practice Address - Street 1:710 N COLLEGE AVE STE B
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-1220
Practice Address - Country:US
Practice Address - Phone:660-563-1430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20090204651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical