Provider Demographics
NPI:1043374382
Name:ELKING, AGNES JOS (LPC)
Entity type:Individual
Prefix:
First Name:AGNES
Middle Name:JOS
Last Name:ELKING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:AGNES
Other - Middle Name:C
Other - Last Name:JOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:214 N CLAY AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-4068
Mailing Address - Country:US
Mailing Address - Phone:314-472-5527
Mailing Address - Fax:
Practice Address - Street 1:214 N CLAY AVE STE 215
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-4068
Practice Address - Country:US
Practice Address - Phone:314-472-5527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004008598101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional