Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jerry Tabak, LCSW

Individual provider Clinical Social Worker · NPI 1114276342

Jerry Tabak, LCSW is a Clinical Social Worker in O Fallon, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2012
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

109 Church St Ste 105
O Fallon, MO 63366-2894
Phone: (636) 294-0015
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 002217 (MO)

Record details

NPI number1114276342
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedSeptember 4, 2012
Last updated in NPPESSeptember 4, 2012

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