Provider Demographics
NPI:1013110451
Name:PASCO-BURKE, ELISABETH ANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ELISABETH
Middle Name:ANN
Last Name:PASCO-BURKE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1601 OLD SOUTH RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-4120
Mailing Address - Country:US
Mailing Address - Phone:636-224-1210
Mailing Address - Fax:636-246-1008
Practice Address - Street 1:6440 S LEWIS AVE STE 2200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1060
Practice Address - Country:US
Practice Address - Phone:888-882-0859
Practice Address - Fax:918-388-9708
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1218103TC1900X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling