CDK Counseling LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

2012040937 Issued in MO

Legal business name

CDK COUNSELING LLC

Practice address

737 Dunn Rd
Hazelwood, MO 63042-1740

Phone

(314) 775-9642

NPI assigned

Sep 25, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Christina Antionette Gawedzinski

Title

Licensed Professional Counselor

Phone

(314) 775-9642

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1073915641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 DUNN RD",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "63042",
            "telephone_number": "314-775-9642",
            "fax_number": "844-332-7543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 DUNN RD",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421740",
            "telephone_number": "314-775-9642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDK COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-25",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "GAWEDZINSKI",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "ANTIONETTE",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "314-775-9642",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MO",
            "license": "2012040937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC LICENSE",
            "identifier": "2012040937",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.