Provider Demographics
NPI:1518516053
Name:HAROWITZ, ELISE (MA, LPC, BC-DMT)
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:HAROWITZ
Suffix:
Gender:F
Credentials:MA, LPC, BC-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 S BRENTWOOD BLVD STE 808
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63144-1344
Mailing Address - Country:US
Mailing Address - Phone:314-971-6115
Mailing Address - Fax:
Practice Address - Street 1:1750 S BRENTWOOD BLVD STE 808
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63144-1344
Practice Address - Country:US
Practice Address - Phone:314-971-6115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-07
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019029825101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional