Domerese, Dereik Lance
Domerese, Dereik Lance is an individual health care provider with primary practice located at 905 Ne Rice Rd Ste B , Lees Summit MO 64086-6300. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Domerese, Dereik Lance can be contacted via phone (816) 223-8522.Contact Information
Primary practice address
905 Ne Rice Rd Ste B
Lees Summit MO 64086-6300
Phone: (816) 223-8522
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 10198 | Kansas |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2016034259 | Missouri |
Profile Details
| NPI number | 1760927586 |
|---|---|
| LBN Legal business name | Domerese, Dereik Lance |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 3rd, 2017 |
| Last updated | Jun 15th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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