Provider Demographics
NPI:1023837309
Name:KORDES, KATHERINE (MS PLPC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:KORDES
Suffix:
Gender:F
Credentials:MS PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 E GREENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-3620
Mailing Address - Country:US
Mailing Address - Phone:760-619-5543
Mailing Address - Fax:
Practice Address - Street 1:300 E SUNSHINE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-2641
Practice Address - Country:US
Practice Address - Phone:417-319-1502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023042189101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor