Active NPI
Rebecca Ehrke, PSY.D.
- Clinical Psychologist
- Creve Coeur, MO
National Provider Identifier
1215049101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20-12001884
- Practice address
- 11457 Olde Cabin Rd
Suite 345
Creve Coeur, MO 63141-7139 - Phone
- (847) 754-7794
- NPI assigned
- Aug 31, 2006
- Last updated
- Apr 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20-12001884 | MO | Primary |
Addresses
Primary practice location
11457 Olde Cabin Rd
Suite 345
Creve Coeur, MO 63141-7139
Mailing address
11457 Olde Cabin Rd Ste 345
Suite 345
Creve Coeur, MO 63141-7192
Phone (847) 754-7794
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 19, 2025 through Feb 19, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20-12001884 | MO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492732800000",
"number": "1215049101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11457 OLDE CABIN RD STE 345",
"address_2": "SUITE 345",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631417192",
"telephone_number": "847-754-7794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11457 OLDE CABIN RD",
"address_2": "SUITE 345",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631417139",
"telephone_number": "847-754-7794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EHRKE",
"first_name": "REBECCA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2017-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "20-12001884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Creve Coeur, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.