Active NPI
Elizabeth Rastberger
- Mental Health Counselor
- Saint Louis, MO
National Provider Identifier
1124609656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 3284 Ivanhoe Ave Ste E
Saint Louis, MO 63139-2246 - Phone
- (314) 675-0056
- NPI assigned
- Apr 16, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2021032461 | MO | |
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
3284 Ivanhoe Ave Ste E
Saint Louis, MO 63139-2246
Mailing address
3284 Ivanhoe Ave Ste E
Saint Louis, MO 63139-2246
Phone (314) 675-0056
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021032461 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710892800000",
"number": "1124609656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3284 IVANHOE AVE STE E",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631392246",
"telephone_number": "314-675-0056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3284 IVANHOE AVE STE E",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631392246",
"telephone_number": "314-675-0056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RASTBERGER",
"first_name": "ELIZABETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-16",
"last_updated": "2024-03-20",
"certification_date": "2024-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2021032461",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.