Sally Koesterer, MSW, LCSW, CEAP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

004811 Issued in MO

Practice address

2646 Highway 109 Ste 203
Wildwood, MO 63040-1162

Phone

(314) 484-7255

NPI assigned

Dec 20, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1104332642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7349 COLGATE AVE",
            "city": "UNIVERSITY CITY",
            "state": "MO",
            "postal_code": "631302932",
            "telephone_number": "314-484-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2646 HIGHWAY 109 STE 203",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630401162",
            "telephone_number": "314-484-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOESTERER",
        "first_name": "SALLY",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW, CEAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-20",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "004811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallory Keppel
• Carol J Kern, OTR/L
• Devin Kilfoy, PHARMD
• Kent L Killian, MD
• Christopher W Kling, M.D.
• Jennifer Komor
• Morgan Victoria Kotva, PHARMD
• Kara Labedz
• Mary Lakey, LPC
• Jonathon E Langenbacher, D.C.

• Clinical Social Worker in Wildwood, MO
• Providers in Wildwood, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; 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.