Provider Demographics
NPI:1598809378
Name:STRACHOCKA-KILE, MONIKA E (LCSW)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:E
Last Name:STRACHOCKA-KILE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2580
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65801-2580
Mailing Address - Country:US
Mailing Address - Phone:417-829-4620
Mailing Address - Fax:417-829-4316
Practice Address - Street 1:1312 E LARK ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-7351
Practice Address - Country:US
Practice Address - Phone:417-820-3707
Practice Address - Fax:417-820-7954
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0027421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO83780OtherAR BLUE SHIELD #
MO496947862Medicaid
MO83780OtherAR BLUE SHIELD #