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NPI Code Detail

MEDICARE: KATHLEEN WALSCH-SHELLI LCSW

MEDICARE:   KATHLEEN  WALSCH-SHELLI  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
11041C0700XClinical Social Worker000258MO

General Provider Information

NPI Number : 1275760647
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN WALSCH-SHELLI LCSW
Provider Business Mailing Address
First Line : 2901 S KINGSHIGHWAY BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63139-1008
Country : US
Telephone Number : 314-664-7793
Fax Number : 314-772-8540
Provider Business Practice Location Address
First Line : 2901 S KINGSHIGHWAY BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63139-1008
Country : US
Telephone Number : 314-664-7793
Fax Number : 314-772-8540
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2009
Last Update Date : 06/12/2009

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Directions to “ KATHLEEN WALSCH-SHELLI LCSW” Practice Location

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