Healthcare Provider Details

I. General information

NPI: 1720181340
Provider Name (Legal Business Name): EVE T DYSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EVE T KAHN LPC

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 THOREAU CT UNIT 307
SAINT LOUIS MO
63146-5551
US

IV. Provider business mailing address

1010 THOREAU CT UNIT 307
SAINT LOUIS MO
63146-5551
US

V. Phone/Fax

Practice location:
  • Phone: 314-220-3692
  • Fax:
Mailing address:
  • Phone: 314-220-3692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCS002779
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: