Provider Demographics
NPI:1720181340
Name:DYSON, EVE T (LPC)
Entity type:Individual
Prefix:
First Name:EVE
Middle Name:T
Last Name:DYSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:EVE
Other - Middle Name:T
Other - Last Name:KAHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1010 THOREAU CT UNIT 307
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-5551
Mailing Address - Country:US
Mailing Address - Phone:314-220-3692
Mailing Address - Fax:
Practice Address - Street 1:1010 THOREAU CT UNIT 307
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-5551
Practice Address - Country:US
Practice Address - Phone:314-220-3692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCS002779101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO494009814Medicaid