MEDICARE: KATHERINE E SCHWENKE M.ED

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	101Y00000X	Counselor
2	101YP2500X	Professional Counselor	2014040796	MO

General Provider Information

NPI Number	:	1568720597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE E SCHWENKE M.ED

Provider Business Mailing Address
First Line	:	1120 SACKMAN CT
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63031-8545
Country	:	US
Telephone Number	:	314-324-7634
Fax Number	:

Provider Business Practice Location Address
First Line	:	2081 COLLIER CORPORATE PKWY
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63303-6701
Country	:	US
Telephone Number	:	636-255-0002
Fax Number	:

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

Provider Enumeration Date	:	04/27/2012
Last Update Date	:	05/28/2019

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