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NPI Code Detail

MEDICARE: CARRIE BOCKENKAMP

MEDICARE: CARRIE BOCKENKAMP
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1396675666
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE BOCKENKAMP
Provider Business Mailing Address
First Line : 3309 S KINGSHIGHWAY BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63139-1101
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1085 MAPLE ST
Second Line :
City : FARMINGTON
State : MO
Zip : 63640-1955
Country : US
Telephone Number : 573-756-5353
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2026
Last Update Date : 05/20/2026

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Directions to “ CARRIE BOCKENKAMP ” Practice Location

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