Basic Information
| Provider Information | |||||||||
| NPI: | 1932586740 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CKATKE COUNSELING SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15455 MANCHESTER RD UNIT 161 | ||||||||
| Address2: | |||||||||
| City: | BALLWIN | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630225008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3145482121 | ||||||||
| FaxNumber: | 3145482121 | ||||||||
| Practice Location | |||||||||
| Address1: | 2200 W PORT PLAZA DR STE 326 | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631463214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3145482121 | ||||||||
| FaxNumber: | 6363334510 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2015 | ||||||||
| LastUpdateDate: | 10/12/2022 | ||||||||
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| AuthorizedOfficialLastName: | KATKE | ||||||||
| AuthorizedOfficialFirstName: | CHRISTY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3145482121 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MSW, LCSW | ||||||||
| NPICertificationDate: | 10/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | SW005494 | MO | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.