Healthcare Provider Details

I. General information

NPI: 1366359515
Provider Name (Legal Business Name): KAITLYN SIERRA PRITCHETT PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 EL NATHAN DR
MARBLE HILL MO
63764-8342
US

IV. Provider business mailing address

103 EL NATHAN DR
MARBLE HILL MO
63764-8342
US

V. Phone/Fax

Practice location:
  • Phone: 573-238-1027
  • Fax: 573-238-1171
Mailing address:
  • Phone: 573-238-1027
  • Fax: 573-238-1171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2026039925
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: