Healthcare Provider Details

I. General information

NPI: 1477497493
Provider Name (Legal Business Name): STEPHANIE ENKE MED, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2026
Last Update Date: 04/18/2026
Certification Date: 04/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 THOMAS AVE
SAINT CHARLES MO
63301-3573
US

IV. Provider business mailing address

405 THOMAS AVE
SAINT CHARLES MO
63301-3573
US

V. Phone/Fax

Practice location:
  • Phone: 636-706-9322
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2025048643
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: