Individual provider Active NPI

Jessica Rosenberg, LPC

  • Counselor
  • Saint Louis, MO
National Provider Identifier
1063987642
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
2014034532 Issued in MO
Practice address
8008 Carondelet Ave Ste 104
Saint Louis, MO 63105-1724
Phone
(314) 920-0569
NPI assigned
Oct 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2014034532 MO Primary

Addresses

Primary practice location

8008 Carondelet Ave Ste 104
Saint Louis, MO 63105-1724

Mailing address

817 Berry Hill Dr
Saint Louis, MO 63132-3502
Phone (314) 920-0569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2014034532MOMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Open Arms Wellness LLC CurrentSince Nov 15, 2020 Accepting new patients
Jessica Rosenberg LLC Counselor Current Accepting new patients

Organizations & group practices 2

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": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1063987642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 BERRY HILL DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631323502",
            "telephone_number": "314-920-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8008 CARONDELET AVE STE 104",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631051724",
            "telephone_number": "314-920-0569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "JESSICA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2014034532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.