| Organization Name: | DYNAMIC COUNSELING AND CONSULTATION SERVICES |
| NPI Number: | 1457771677 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CARRIE CROCKER (OWNER) |
| Mailing Address: | 3600 S Water Tower Pl Mt Vernon |
| State: | IL US |
| Postal Code: | 62864 |
| Phone Number: | 3147196263 |
| Fax Number: | 8003354761 |
| NPI Enumeration Date: | 04/27/2014 |
| NPI Last Update Date: | 11/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 2003032196 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |