MEDICARE: MS. ELIZABETH REINBERG MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker
2	104100000X	Social Worker	2011036714	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2016038354	OTHER	MO	STATE LICENSE

General Provider Information

NPI Number	:	1669759783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH REINBERG MSW, LCSW

Provider Business Mailing Address
First Line	:	2650 OLIVE ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63103-1489
Country	:	US
Telephone Number	:	314-802-2647
Fax Number	:	314-842-2552

Provider Business Practice Location Address
First Line	:	11166 TESSON FERRY RD STE 300
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-6966
Country	:	US
Telephone Number	:	314-802-2647
Fax Number	:	314-842-2552

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2011
Last Update Date	:	08/01/2022

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