Provider Demographics
NPI:1760504013
Name:WOODARD, DAVID C (LMSW)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:WOODARD
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 W COURT ST
Mailing Address - Street 2:APT. 305
Mailing Address - City:CLAY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67432-2316
Mailing Address - Country:US
Mailing Address - Phone:785-632-5844
Mailing Address - Fax:
Practice Address - Street 1:2653 LOCUST ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-1411
Practice Address - Country:US
Practice Address - Phone:855-751-8879
Practice Address - Fax:833-529-0574
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20220067451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical