Healthcare Provider Details

I. General information

NPI: 1497244180
Provider Name (Legal Business Name): EMILY KATE KOTHE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2018
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 S BRENTWOOD BLVD
RICHMOND HEIGHTS MO
63117-1223
US

IV. Provider business mailing address

2705 SHENANDOAH AVE
SAINT LOUIS MO
63104-2313
US

V. Phone/Fax

Practice location:
  • Phone: 314-328-7958
  • Fax:
Mailing address:
  • Phone: 573-822-1059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2018028490
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: