Healthcare Provider Details

I. General information

NPI: 1275833972
Provider Name (Legal Business Name): SHEARL DOLEJSI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2010
Last Update Date: 04/01/2026
Certification Date: 02/03/2022
Deactivation Date: 02/03/2022
Reactivation Date: 04/01/2026

III. Provider practice location address

2 WESTBURY DR
SAINT CHARLES MO
63301-2558
US

IV. Provider business mailing address

900 E LAHARPE ST
KIRKSVILLE MO
63501-4520
US

V. Phone/Fax

Practice location:
  • Phone: 636-946-6376
  • Fax: 636-946-6479
Mailing address:
  • Phone: 660-665-1962
  • Fax: 660-665-3989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number005691
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: