JERRY TABAK LCSW
NPI 1114276342
Social Worker - Clinical in O Fallon, MO

Active since September 04, 2012
109 CHURCH ST, SUITE 105, O FALLON, MO 63366(636) 294-0015 Get Directions Write a Review

NPPES record last updated: September 4, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jerry Tabak Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERRY TABAK LCSW (NPI 1114276342) is an individual clinical provider in O Fallon, Missouri, licensed in Missouri (002217) and active in the NPI registry since September 2012.

NPPES Registry Identity

NPI1114276342
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameJERRY TABAKCredential: LCSW
Location Address109 CHURCH ST, SUITE 105O Fallon, MO 63366-2894
Mailing Address109 Church St, Suite 105O Fallon, MO 63366-2894 · (636) 294-0015
Sole ProprietorYes
Enumeration DateSeptember 4, 2012
NPI 1114276342 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in MO · 002217
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
109 CHURCH ST, O Fallon, MO 63366

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Chiropractor
109 CHURCH ST
O FALLON, MO 63366
Chiropractor
109 CHURCH ST
O FALLON, MO 63366
Counselor
109 CHURCH ST
O FALLON, MO 63366
Chiropractor
109 CHURCH ST
O FALLON, MO 63366
Chiropractor
109 CHURCH ST
O FALLON, MO 63366
Case Management
109 CHURCH ST, SUITE 105
O FALLON, MO 63366

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerry Tabak's NPI number?

The NPI number for Jerry Tabak is 1114276342. It was assigned to this individual provider in the NPPES registry on September 4, 2012.

Where is Jerry Tabak located?

Jerry Tabak practices at 109 Church St Suite 105, O Fallon, MO 63366. The listed phone number is (636) 294-0015.

What is Jerry Tabak's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Jerry Tabak was last updated on September 4, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.