Provider Demographics
NPI:1093816720
Name:KATKE, CHRISTY (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:KATKE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15455 MANCHESTER RD UNIT 161
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63022-5008
Mailing Address - Country:US
Mailing Address - Phone:314-548-2121
Mailing Address - Fax:636-333-4510
Practice Address - Street 1:2200 W PORT PLAZA DR STE 326
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-3214
Practice Address - Country:US
Practice Address - Phone:314-548-2121
Practice Address - Fax:636-333-4510
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW0054941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO178672OtherBLUE CROSS BLUE SHIELD
MO440586OtherHEALTHLINK