Individual provider Active NPI

Elizabeth Freeman, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1861380099
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2003007952 Issued in MO
Practice address
12818 Tesson Ferry Rd Ste 103
Saint Louis, MO 63128-2945
Phone
(314) 912-4655
NPI assigned
Jun 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2003007952 MO Primary

Addresses

Primary practice location

12818 Tesson Ferry Rd Ste 103
Saint Louis, MO 63128-2945

Mailing address

68 Conway Cove Dr
Chesterfield, MO 63017-2070
Phone (636) 578-7622

Other practice location 1

68 Conway Cove Dr
Chesterfield, MO 63017-2070
Phone (636) 578-7622

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
I20250716003846 MO Practitioner - Clinical Social Worker 9335654425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mypathtoself IncGroup PAC ID 4082088323, 11 clinicians

Practice addresses (Care Compare)

12818 Tesson Ferry Rd
Suite 103
Saint Louis, MO 63128-2945
Phone (314) 923-4655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2003007952MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mypathtoself Inc. CurrentSince Jul 10, 2025 Accepting new patients

Locations

12818 Tesson Ferry Rd
Ste 103
Saint Louis, MO 63128
Phone (314) 912-4655

2464 Taylor Rd
Wildwood, MO 63040

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": "1750896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1861380099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 CONWAY COVE DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172070",
            "telephone_number": "636-578-7622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12818 TESSON FERRY RD STE 103",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282945",
            "telephone_number": "314-912-4655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Conway Cove Dr",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630172070",
            "country_code": "US",
            "telephone_number": "636-578-7622",
            "fax_number": "636-578-7622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-26",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2003007952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.