CM Kinney and Associates, LLC

Organization Active NPI Clinical Social Worker · Manchester, MO

NPI 1033734702 · NPPES record last updated Apr 22, 2022

Key facts

NPI
1033734702
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Social Worker 1041C0700X
Legal business name
CM KINNEY AND ASSOCIATES, LLC
Practice address
623 Meramec Station Rd
Manchester, MO 63021-5550
Phone
(314) 266-9131
NPI assigned
Jun 9, 2020
Organization subpart
No

Authorized official

Name
Victoria Shepherd
Title
Admim
Phone
(314) 315-5148

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200729000997 MO Part B Supplier - Clinic/Group Practice 4688099328 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO

National Provider Directory

Locations

623 Meramec Station Rd
Manchester, MO 63021
Phone (314) 266-9131

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker
Group: 193400000X SINGLE SPECIALTY GROUP
1041C0700X Yes

Addresses

Primary practice location

623 Meramec Station Rd
Manchester, MO 63021-5550

Mailing address

1237 Warson Woods Dr
Saint Louis, MO 63122-1735
Phone (314) 608-2527

Other providers in Manchester, MO

All providers in Manchester, MO · Clinical Social Worker in Missouri

Sources for this page

Verify at the official NPI Registry.