Healthcare Provider Details

I. General information

NPI: 1063604841
Provider Name (Legal Business Name): CHRISTINA HECKENKAMP SCHULTE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 04/02/2022
Certification Date: 04/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MEADOWLAKE DR
SAINT CHARLES MO
63304-1226
US

IV. Provider business mailing address

401 MEADOWSIDE CT
SAINT CHARLES MO
63304-3503
US

V. Phone/Fax

Practice location:
  • Phone: 314-374-5994
  • Fax:
Mailing address:
  • Phone: 314-374-5994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2005030351
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: