Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Phyne Kierra Ann Pettis

Individual provider Clinical Social Worker · NPI 1104704048

Phyne Kierra Ann Pettis is a Clinical Social Worker in Saint Louis, Missouri. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

3309 S Kingshighway Blvd
Saint Louis, MO 63139-1101
Phone: (314) 206-3700
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1104704048
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 26, 2025
Last updated in NPPESAugust 26, 2025
Certification dateAugust 26, 2025

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