Organization
KRISTEN CAROTHERS MSW LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILI GIUFFRA (MANAGER)
(314) 222-5882
Entity
Organization
Contact information
Practice address
9890 CLAYTON RD STE 100, SAINT LOUIS, MO 63124-1685
(314) 222-5882
(314) 222-5883
Mailing address
9890 CLAYTON RD STE 100, SAINT LOUIS, MO 63124-1685
(314) 222-5882
(314) 222-5883
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2012013694
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA2798
MEDICARE PTAN
MO
Enumeration date
11/28/2016
Last updated
11/28/2016
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