Provider Demographics
NPI:1053886077
Name:KIRKENMEIER, KATIE ANN (MA, LPC, ATR)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:ANN
Last Name:KIRKENMEIER
Suffix:
Gender:F
Credentials:MA, LPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 E 63RD ST STE 240
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-3331
Mailing Address - Country:US
Mailing Address - Phone:573-694-7212
Mailing Address - Fax:
Practice Address - Street 1:633 E 63RD ST STE 240
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-3331
Practice Address - Country:US
Practice Address - Phone:573-694-7212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018010407101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional