Healthcare Provider Details

I. General information

NPI: 1134244353
Provider Name (Legal Business Name): THE CHILDREN'S HOME SOCIETY OF MISSOURI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11358 VAN CLEVE AVE
SAINT LOUIS MO
63114-1131
US

IV. Provider business mailing address

11358 VAN CLEVE AVE
SAINT LOUIS MO
63114-1131
US

V. Phone/Fax

Practice location:
  • Phone: 314-534-9350
  • Fax: 314-968-4239
Mailing address:
  • Phone: 314-534-9350
  • Fax: 314-968-4239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number005345
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAREN ELIZABETH NOLTE
Title or Position: CEO
Credential:
Phone: 314-348-2210