Provider Demographics
NPI:1477448009
Name:BOCK, DANA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:
Last Name:BOCK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 N CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62221-4026
Mailing Address - Country:US
Mailing Address - Phone:618-580-4708
Mailing Address - Fax:
Practice Address - Street 1:1826 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62221-4026
Practice Address - Country:US
Practice Address - Phone:618-580-4708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20210256871041C0700X
IL149.0223941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical