Adam Ketcherside, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2014007562 Issued in MO

Practice address

10024 Office Center Ave Ste 100
Saint Louis, MO 63128-1392

Phone

(314) 729-7050

Fax

(314) 729-0920

NPI assigned

Aug 21, 2014

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

State licenses

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408579200000",
    "number": "1467851824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E LAHARPE ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014520",
            "telephone_number": "660-665-1962",
            "fax_number": "660-665-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10024 OFFICE CENTER AVE STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631281392",
            "telephone_number": "314-729-7050",
            "fax_number": "314-729-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHERSIDE",
        "first_name": "ADAM",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2014007562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alaina Justine Kessler, MD
• Elizabeth Pescia Kessler, PLPC
• Ashleigh Lauren Kester, PT, DPT
• Rachel Anne Kestner, ACNP
• Rajesh N Keswani, MD
• Emily Ketcherside, MOT, OTR/L
• Sonja Marie Ketcherside, RDH
• Monica Ketchum, DO, MA
• Stefanee L Keth, PNP
• Kristen Marie Kettenbach, RD, LMSW

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, 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 Aug 21, 2014; 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.