Healthcare Provider Details

I. General information

NPI: 1497529085
Provider Name (Legal Business Name): CASEY MARIE KUTRIP LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2023
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 15
MORSE MILL MO
63066-0015
US

IV. Provider business mailing address

PO BOX 15
MORSE MILL MO
63066-0015
US

V. Phone/Fax

Practice location:
  • Phone: 636-484-4466
  • Fax:
Mailing address:
  • Phone: 636-484-4466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2025054046
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: