Provider Demographics
NPI:1720893357
Name:INKLEY, KRISTIN (LMSW)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:INKLEY
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 ROCK CREEK ELEMENTARY SCHOOL DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-7577
Mailing Address - Country:US
Mailing Address - Phone:636-294-5787
Mailing Address - Fax:
Practice Address - Street 1:1100 ROCK CREEK ELEMENTARY SCHOOL DR
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-7577
Practice Address - Country:US
Practice Address - Phone:636-294-5787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025001768104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker