Individual provider Active NPI

Katie Ingebretson, MSW, LCSW

  • Clinical Social Worker
  • O'Fallon, MO
National Provider Identifier
1366725277
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
311 S Main St
O Fallon, MO 63366-2807
Phone
(636) 281-1990
NPI assigned
Sep 27, 2011
Last updated
Apr 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

311 S Main St
O Fallon, MO 63366-2807

Mailing address

311 S. Main St.
O Fallon, MO 63366
Phone (636) 281-1990

Other names 1

  • Katie Pickett Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150521002669 MO Practitioner - Clinical Social Worker 8224358833 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St Louis Counseling Inc CurrentSince Apr 18, 2015 Accepting new patients
Catholic Family Services Inc. CurrentSince Apr 18, 2015 Accepting new patients

Locations

5 Premier Dr
Ste 200
Fenton, MO 63026
Phone (314) 314-3800

9200 Watson Rd
Ste G101
Saint Louis, MO 63126
Phone (314) 367-5500

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1366725277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S. MAIN ST.",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "63366",
            "telephone_number": "636-281-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S MAIN ST",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662807",
            "telephone_number": "636-281-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGEBRETSON",
        "first_name": "KATIE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "PICKETT",
            "credential": "MSW, LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in O'Fallon, MO

Sources for this page

Verify at the official NPI Registry.