Healthcare Provider Details

I. General information

NPI: 1376101444
Provider Name (Legal Business Name): KYLIE LORRAINE RAPP PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2019
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 N MAIN ST
SAINT CLAIR MO
63077-1261
US

IV. Provider business mailing address

1280 DIANE ST
SAINT CLAIR MO
63077-1618
US

V. Phone/Fax

Practice location:
  • Phone: 314-808-1250
  • Fax:
Mailing address:
  • Phone: 636-584-1843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2023006213
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: