Individual provider Active NPI

Catherine Christine Wilke, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1720528821
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2018007941 Issued in MO
Practice address
3114 Sutton Blvd
Saint Louis, MO 63143-3910
Phone
(314) 973-2508
Fax
(314) 781-7914
NPI assigned
Mar 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2015003421 MO
Clinical Social Worker 1041C0700X 2018007941 MO Primary

Addresses

Primary practice location

3114 Sutton Blvd
Saint Louis, MO 63143-3910

Mailing address

3114 Sutton Blvd
Saint Louis, MO 63143-3910
Phone (314) 973-2508

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
I20201006001739 MO Practitioner - Clinical Social Worker 4082033345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Bridges Community Support ServicesGroup PAC ID 2961418629, 8 clinicians

Practice addresses (Care Compare)

3155 Sutton Blvd
Suite 201
Maplewood, MO 63143-3917
Phone (314) 781-7900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2015003421MOMDMental Health Counselor
2018007941MOMDClinical Social Worker

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1720528821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3114 SUTTON BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631433910",
            "telephone_number": "314-973-2508",
            "fax_number": "314-781-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3114 SUTTON BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631433910",
            "telephone_number": "314-973-2508",
            "fax_number": "314-781-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKE",
        "first_name": "CATHERINE",
        "middle_name": "CHRISTINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-08",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2015003421",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2018007941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.