Provider Demographics
NPI:1316489891
Name:SPITZER, KERRI LOUISE (PLPC)
Entity type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:LOUISE
Last Name:SPITZER
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:MISS
Other - First Name:KERRI
Other - Middle Name:LOUISE
Other - Last Name:SPITZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:724 N 22ND ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2604
Mailing Address - Country:US
Mailing Address - Phone:816-236-2322
Mailing Address - Fax:816-364-4211
Practice Address - Street 1:724 N 22ND ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2604
Practice Address - Country:US
Practice Address - Phone:816-236-2322
Practice Address - Fax:816-364-4211
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016040023101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health