Pamela Kueker, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149014566 Issued in IL

Practice address

104 Northtown Rd
Sparta, IL 62286-1081

Phone

(618) 443-3045

NPI assigned

Jan 14, 2011

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 14, 2011.

{
    "created_epoch": "1294963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1366747768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10257 STATE ROUTE 3",
            "city": "RED BUD",
            "state": "IL",
            "postal_code": "622784418",
            "telephone_number": "618-282-6233",
            "fax_number": "618-282-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 NORTHTOWN RD",
            "city": "SPARTA",
            "state": "IL",
            "postal_code": "622861081",
            "telephone_number": "618-443-3045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUEKER",
        "first_name": "PAMELA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-14",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamia Klausing, LCSW
• Amy Lyn Kloos, PHARM.D.
• Seamus Neal Kloos, PHARM.D.
• Rebecca Koopman, ATC
• Amy Lynn Koudelka
• Dana Lakatos, PA-C
• Abigail Landewee
• Lifenet, Inc.
• Melissa Sue Lindsey, OTRL
• Emily Loesing

• All providers in Sparta, IL
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; 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.