Healthcare Provider Details

I. General information

NPI: 1265164289
Provider Name (Legal Business Name): ABIGAIL ZALOUDEK LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 N GORE AVE
SAINT LOUIS MO
63119-1600
US

IV. Provider business mailing address

330 N GORE AVE
SAINT LOUIS MO
63119-1600
US

V. Phone/Fax

Practice location:
  • Phone: 314-964-6927
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2022021047
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: