Provider Demographics
NPI:1588957203
Name:ORR, ELIZABETH A (LCPC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:ORR
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4977 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-1249
Mailing Address - Country:US
Mailing Address - Phone:314-640-9287
Mailing Address - Fax:
Practice Address - Street 1:4977 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-1249
Practice Address - Country:US
Practice Address - Phone:314-640-9287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005890101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional