Individual provider Active NPI

Kathryn E Tenkku, MSW, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1790289601
Registry record updated Mar 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2016021043 Issued in MO
Practice address
10805 Sunset Office Dr Ste L108
Saint Louis, MO 63127-1025
Phone
(314) 909-4804
NPI assigned
Mar 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2018

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 2016021043 MO Primary

Addresses

Primary practice location

10805 Sunset Office Dr Ste L108
Saint Louis, MO 63127-1025

Mailing address

10805 Sunset Office Dr Ste L108
Saint Louis, MO 63127-1025
Phone (314) 909-4804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2016021043MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1790289601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10805 SUNSET OFFICE DR STE L108",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271025",
            "telephone_number": "314-909-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10805 SUNSET OFFICE DR STE L108",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271025",
            "telephone_number": "314-909-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENKKU",
        "first_name": "KATHRYN",
        "middle_name": "E",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2016021043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.