Matthew Douglas Kliethermes, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

2004024732 Issued in MO

Practice address

1 University Blvd
Weinman BLDG-Upper Level
Saint Louis, MO 63121-4400

Phone

(314) 516-7231

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

No

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

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255489902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12112 JEANNETTE MARY DR",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630434221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY BLVD",
            "address_2": "WEINMAN BLDG-UPPER LEVEL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631214400",
            "telephone_number": "314-516-7231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIETHERMES",
        "first_name": "MATTHEW",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MO",
            "license": "2004024732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Klevorn
• Olivia Kleyer, MED, BCBA, LBA
• Eric Klick, AGACNP
• Matthew Paul Klick, D.O.
• Austin Kliefoth
• Suzanne Lee Kliewer, MS, CCC-SLP
• Nicholas Arthur Klimeck-Jones, PA
• Courtney Kline, OTR/L
• Emma M Kline, DO
• Jaclyn Kline, BCBA, LBA, LPC

• Clinical Child & Adolescent Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Child & Adolescent Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.