Provider Demographics
NPI:1881944643
Name:GLOVER, PHOEBE J (LCSW)
Entity type:Individual
Prefix:MRS
First Name:PHOEBE
Middle Name:J
Last Name:GLOVER
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 1:1230 N DUQUESNE RD
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64801-1509
Mailing Address - Country:US
Mailing Address - Phone:417-782-1443
Mailing Address - Fax:
Practice Address - Street 1:2243 COUNTY LANE 175
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-7416
Practice Address - Country:US
Practice Address - Phone:417-437-1583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110020751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical