Provider Demographics
NPI:1538782420
Name:SPEER, ARIELLE RENEE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ARIELLE
Middle Name:RENEE
Last Name:SPEER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ARIELLE
Other - Middle Name:R
Other - Last Name:SHORT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:509 MDG 331
Mailing Address - Street 2:SIJAN AVENUE
Mailing Address - City:WHITEMAN AFB
Mailing Address - State:MO
Mailing Address - Zip Code:65305
Mailing Address - Country:US
Mailing Address - Phone:660-687-7222
Mailing Address - Fax:
Practice Address - Street 1:509 MDG 331 SIJAN AVENUE
Practice Address - Street 2:
Practice Address - City:WHITEMAN AFB
Practice Address - State:MO
Practice Address - Zip Code:65305-1462
Practice Address - Country:US
Practice Address - Phone:660-687-7222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20190271791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical