Elizabeth Provencio

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2024037080 Issued in MO

Practice address

4554 Laclede Ave Apt 308
Saint Louis, MO 63108-2147

Phone

(217) 553-1786

NPI assigned

Aug 12, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Elizabeth Pike Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Busy Bee Speech Therapy, LLC

  • Speech-Language Pathologist
  • Saint Louis, MO
  • NPI 1407461635
  NPD

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1457182214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BOSCHERT CREEK DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633765951",
            "telephone_number": "575-635-2516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4554 LACLEDE AVE APT 308",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082147",
            "telephone_number": "217-553-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVENCIO",
        "first_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2024037080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "PIKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Prosthetic Design Inc (Orthotic & Prosthetic Design Inc)
• Prosthetic Design Inc (Orthotic & Prosthetic Design Inc)
• Rachel Protzel, MSW, LCSW
• Anele M Proudfoot, AA-C
• Rosa M. Prouhet, CNP
• Provide Dental
• Provident Counseling
• Provident in Home Services, LLC
• Provident Inc (Provident Behavioral Health)
• Provident Inc. (Provident Behavioral Health)

• Speech-Language Pathologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.