MEDICARE: MRS. TAMMY R KAEMPFE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	2001000520	MO

General Provider Information

NPI Number	:	1194707240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAMMY R KAEMPFE LCSW

Provider Business Mailing Address
First Line	:	207 S 5TH ST
Second Line	:	P O BOX 1094
City	:	POPLAR BLUFF
State	:	MO
Zip	:	63901-7310
Country	:	US
Telephone Number	:	573-778-0382
Fax Number	:

Provider Business Practice Location Address
First Line	:	2725 N WESTWOOD BLVD STE 5
Second Line	:
City	:	POPLAR BLUFF
State	:	MO
Zip	:	63901-2367
Country	:	US
Telephone Number	:	573-872-4671
Fax Number	:	573-872-4675

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	02/22/2023

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