Provider Demographics
NPI:1982294567
Name:STRUTTMANN, KARLEIGH MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:KARLEIGH
Middle Name:MARIE
Last Name:STRUTTMANN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KARLEIGH
Other - Middle Name:MARIE
Other - Last Name:STITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1601 OLD SOUTH RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-4120
Mailing Address - Country:US
Mailing Address - Phone:636-224-1210
Mailing Address - Fax:636-246-1008
Practice Address - Street 1:7020 CHIPPEWA ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-5602
Practice Address - Country:US
Practice Address - Phone:314-772-2205
Practice Address - Fax:314-772-9264
Is Sole Proprietor?:No
Enumeration Date:2021-01-19
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020027584104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker