Individual provider Active NPI

Elizabeth Helen Davis, PH.D.

  • Clinical Psychologist
  • Kirkwood, MO
National Provider Identifier
1811214158
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2010009570 Issued in MO
Practice address
140 Prospect Ave Ste N
Kirkwood, MO 63122-6074
Phone
(314) 884-0808
Fax
(314) 899-5799
NPI assigned
Apr 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2010009570 MO Primary

Addresses

Primary practice location

140 Prospect Ave Ste N
Kirkwood, MO 63122-6074

Mailing address

140 Prospect Ave Ste N
Kirkwood, MO 63122-6074
Phone (314) 884-0808

Other identifiers 1

IdentifierTypeStateIssuer
2010009570OtherMOMISSOURI PSYCHOLOGY LICENSE

Other names 1

  • Liz Davis Davis Goldman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260303000119 MO Practitioner - Clinical Psychologist 7719469543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

140 Prospect Ave
Suite N
Kirkwood, MO 63122-6024

1756 Royston Dr
San Diego, CA 92154-2853

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2010009570MOMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Affirming Care Psychotherapy LLC Clinical CurrentSince Oct 25, 2025 Accepting new patients

Locations

140 Prospect Ave
Ste N
Kirkwood, MO 63122
Phone (314) 884-0180

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1811214158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 PROSPECT AVE STE N",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226074",
            "telephone_number": "314-884-0808",
            "fax_number": "314-899-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PROSPECT AVE STE N",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226074",
            "telephone_number": "314-884-0808",
            "fax_number": "314-899-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ELIZABETH",
        "middle_name": "HELEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-27",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2010009570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI PSYCHOLOGY LICENSE",
            "identifier": "2010009570",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIZ",
            "last_name": "DAVIS GOLDMAN",
            "middle_name": "DAVIS",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kirkwood, MO

Sources for this page

Verify at the official NPI Registry.