Healthcare Provider Details

I. General information

NPI: 1023601796
Provider Name (Legal Business Name): JESSICA BECKMANN SCHENK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2021
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BROOKINGS DR
SAINT LOUIS MO
63130-4862
US

IV. Provider business mailing address

PO BOX 7412043
CHICAGO IL
60674-2043
US

V. Phone/Fax

Practice location:
  • Phone: 314-935-6666
  • Fax: 314-696-1214
Mailing address:
  • Phone: 314-935-6666
  • Fax: 314-696-1214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2021001136
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2021001136
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: