Clarice Karine Gerke, PH.D.
Individual provider Active NPI Clinical Psychologist · Weldon Spring, MO
NPI 1497051411 · NPPES record last updated Mar 17, 2021
Key facts
- NPI
- 1497051411
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 2011000215 (MO)
- Practice address
- 500 Huber Park CT Ste 205
Weldon Spring, MO 63304-8683 - Phone
- (636) 300-9922
- NPI assigned
- Feb 9, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Susic Psychological Consulting, PC
Practice addresses (Care Compare)
500 Huber Park CT
Suite 205
Weldon Spring, MO 63304-8683
Phone (636) 300-9922
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110720000765 | MO | Practitioner - Clinical Psychologist | 7113195041 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011000215 | MO | MD | Clinical Psychologist |
| 0810004008 | VA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Susic Psychological Consulting, PC | Clinical | Current |
Accepting new patients |
Locations
500 Huber Park Ct
Ste 205
Weldon Spring, MO 63304
Phone (636) 300-9922
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810004008 | VA | |
| Clinical Psychologist | 103TC0700X | 2011000215 | MO | Yes |
Addresses
Primary practice location
500 Huber Park CT Ste 205
Weldon Spring, MO 63304-8683
Mailing address
5505 Rosa Ave
Saint Louis, MO 63109-3249
Phone (314) 210-3869
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All providers in Weldon Spring, MO · Clinical Psychologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.