Individual provider Active NPI

Elizabeth Suzanne Matoushek, LICSW

  • Social Worker
  • Ballwin, MO
National Provider Identifier
1144770322
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
28682 Issued in MN
Practice address
1012 Julianna Dr
Ballwin, MO 63011-3638
Phone
(314) 775-7334
NPI assigned
Oct 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 28682 MN Primary

Addresses

Primary practice location

1012 Julianna Dr
Ballwin, MO 63011-3638

Mailing address

1012 Julianna Dr
Ballwin, MO 63011-3638
Phone (314) 775-7334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28682MNMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1144770322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 JULIANNA DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113638",
            "telephone_number": "314-775-7334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 JULIANNA DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113638",
            "telephone_number": "314-775-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOUSHEK",
        "first_name": "ELIZABETH",
        "middle_name": "SUZANNE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-11",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "28682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

Verify at the official NPI Registry.