Provider Demographics
NPI:1285215905
Name:HOEFER, KATIE LOU (LPC)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:LOU
Last Name:HOEFER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 DOUGLAS DR APT J
Mailing Address - Street 2:
Mailing Address - City:PARK HILLS
Mailing Address - State:MO
Mailing Address - Zip Code:63601-2293
Mailing Address - Country:US
Mailing Address - Phone:573-210-8940
Mailing Address - Fax:
Practice Address - Street 1:400 N WASHINGTON ST STE 232
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-1702
Practice Address - Country:US
Practice Address - Phone:573-756-6444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013022739101YM0800X, 101Y00000X
MO2020043292101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health