Provider Demographics
NPI:1194881870
Name:EATON, ELIZABETH (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:EATON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S WOODLAWN
Mailing Address - Street 2:SUITE 29
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-7646
Mailing Address - Country:US
Mailing Address - Phone:636-379-1779
Mailing Address - Fax:
Practice Address - Street 1:801 S WOODLAWN
Practice Address - Street 2:SUITE 29
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-7646
Practice Address - Country:US
Practice Address - Phone:636-379-1779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0025591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical