Provider Demographics
NPI:1003594243
Name:ERNEST, ELIZABETH HANNAH (LMFT LMSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HANNAH
Last Name:ERNEST
Suffix:
Gender:F
Credentials:LMFT LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5587 WAVECREST CIR
Mailing Address - Street 2:
Mailing Address - City:COTTLEVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63304-8043
Mailing Address - Country:US
Mailing Address - Phone:812-454-6913
Mailing Address - Fax:
Practice Address - Street 1:967 GARDENVIEW OFFICE PKWY
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-5917
Practice Address - Country:US
Practice Address - Phone:812-454-6913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MO2022005185106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical