Healthcare Provider Details

I. General information

NPI: 1013872712
Provider Name (Legal Business Name): ELIZABETH VON PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 N KIRKWOOD RD
SAINT LOUIS MO
63122-4362
US

IV. Provider business mailing address

185 TURNBERRY PL APT K
SAINT PETERS MO
63376-4457
US

V. Phone/Fax

Practice location:
  • Phone: 314-270-2285
  • Fax:
Mailing address:
  • Phone: 636-697-5805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: