MEDICARE: KRISTIN KORTE CADC, CPS, MARS, PPF

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	13181	MO

General Provider Information

NPI Number	:	1437013646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN KORTE CADC, CPS, MARS, PPF

Provider Business Mailing Address
First Line	:	105 CLARK ST
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63031-5706
Country	:	US
Telephone Number	:	314-642-2693
Fax Number	:	314-642-2693

Provider Business Practice Location Address
First Line	:	4444 FOREST PARK AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-2212
Country	:	US
Telephone Number	:	314-642-2693
Fax Number	:

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

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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