MEDICARE: KRYSTAL KAY DEWITT LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	003653	MO

General Provider Information

NPI Number	:	1205118197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRYSTAL KAY DEWITT LCSW

Provider Business Mailing Address
First Line	:	4463 HESTERS WAY
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63304-7756
Country	:	US
Telephone Number	:	636-795-8784
Fax Number	:

Provider Business Practice Location Address
First Line	:	2743 RUSSELL BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63104-2137
Country	:	US
Telephone Number	:	573-864-9743
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2011
Last Update Date	:	09/15/2011

Similar Medicare Providers

1336209311 — DR. DALE ALLEN MAXVILLE JR. PHD BCBA-D
Practice Location Address:

2743 RUSSELL BLVD
SAINT LOUIS, MO
63104-2137

Practice Phone: 573-864-9743
Practice Fax: 573-874-1723

1770879421 — GREEN, MAXVILLE, AND ASSOCIATES
Practice Location Address:

2743 RUSSELL BLVD
SAINT LOUIS, MO
63104-2137

Practice Phone: 573-864-9743
Practice Fax:

1336533801 — SYDNEY POGUE OTR/L
Practice Location Address:

2743 RUSSELL BLVD
SAINT LOUIS, MO
63104-2137

Practice Phone: 314-424-2948
Practice Fax:

1629960034 — JUDY HICKS
Practice Location Address:

2701 RUSSELL BLVD
SAINT LOUIS, MO
63104-2137

Practice Phone: 314-598-7636
Practice Fax: 314-598-7636

1548610090 — MAHMOOD ABOSARA
Practice Location Address:

4333 MANCHESTER AVE
SAINT LOUIS, MO
63110-2137

Practice Phone: 314-665-9672
Practice Fax:

1528598406 — QUEEN HOME CARE, LLC
Practice Location Address:

4333 MANCHESTER AVE
SAINT LOUIS, MO
63110-2137

Practice Phone: 314-303-0433
Practice Fax:

Directions to “ KRYSTAL KAY DEWITT LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.