Healthcare Provider Details

I. General information

NPI: 1609640101
Provider Name (Legal Business Name): KATE ROTHMAN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2023
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 ELBRIDGE PAYNE RD STE 1300
CHESTERFIELD MO
63017-8538
US

IV. Provider business mailing address

1415 ELBRIDGE PAYNE RD STE 1300
CHESTERFIELD MO
63017-8538
US

V. Phone/Fax

Practice location:
  • Phone: 636-898-2060
  • Fax: 636-898-2062
Mailing address:
  • Phone: 636-898-2060
  • Fax: 636-898-2062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071.011047
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2021042340
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: