Alice G Vlietstra, PH.D.

Primary specialty

Health Service PsychologistTaxonomy code 103TH0100X

License

01089 Issued in MO

Practice address

745 Craig Rd Ste 102C
Saint Louis, MO 63141-7122

Phone

(314) 729-2855

Fax

(314) 529-3534

NPI assigned

Mar 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Clinical Psychologist

Education

Other, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Positive Family Dynamics,PC

  dba positive family living

  • Health Service Psychologist
  • Saint Louis, MO
  • NPI 1568732550
  Medicare reassignment NPD Authorized official
• Christian Counseling and Psychological Services

  • Psychologist
  • Maryland Heights, MO
  • NPI 1881861615
  NPD (past)

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1841324753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3042 ANDOVER DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631214606",
            "telephone_number": "314-882-5537",
            "fax_number": "314-529-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 CRAIG RD STE 102C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417122",
            "telephone_number": "314-729-2855",
            "fax_number": "314-529-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLIETSTRA",
        "first_name": "ALICE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MO",
            "license": "01089",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MO",
            "license": "300075",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1601",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "075243",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Y. Viyuoh, MD
• Lior Vardi Vizel, MD
• Gregory Riccardo Vlacich, MD
• Gary Vlahovich, D.O.
• Julie Lynn Vlasich, OTR
• Chan P Vo, MD
• Daniel Tien Vo, MD
• John Tuan-Kiet Vo, DO
• Katie D Vo, MD
• Mi Nguyen Vo, MD

• Health Service Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Health Service Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.