Provider Demographics
NPI:1790726792
Name:KASPER, C JAMES (MSW)
Entity Type:Individual
Prefix:MR
First Name:C
Middle Name:JAMES
Last Name:KASPER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 PIONEER DR
Mailing Address - Street 2:
Mailing Address - City:ST PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-5003
Mailing Address - Country:US
Mailing Address - Phone:636-970-1940
Mailing Address - Fax:
Practice Address - Street 1:103 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-1603
Practice Address - Country:US
Practice Address - Phone:636-978-6901
Practice Address - Fax:636-978-0244
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW 0004011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical