Active NPI
Madison Derousse, PLPC
- Mental Health Counselor
- Kirkwood, MO
National Provider Identifier
1568238558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 2024014799
- Practice address
- 214 Clay Street
Suite 215
Kirkwood, MO 63122 - Phone
- (573) 880-6536
- NPI assigned
- Nov 30, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 2024014799 | MO | Primary |
Addresses
Primary practice location
214 Clay Street
Suite 215
Kirkwood, MO 63122
Mailing address
214 N Clay Ave Ste 215
Kirkwood, MO 63122-4068
Phone (573) 880-6536
Other practice location 1
7190 Christopher Dr
Saint Louis, MO 63129-5514
Phone (314) 464-2094
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2024014799 | MO | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A W Stevenson LLC | Professional | Past | Accepting new patients |
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": "1701302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747180800000",
"number": "1568238558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 N CLAY AVE STE 215",
"city": "KIRKWOOD",
"state": "MO",
"postal_code": "631224068",
"telephone_number": "573-880-6536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 CLAY STREET",
"address_2": "SUITE 215",
"city": "KIRKWOOD",
"state": "MO",
"postal_code": "63122",
"telephone_number": "573-880-6536"
}
],
"practiceLocations": [
{
"address_1": "7190 Christopher Dr",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631295514",
"country_code": "US",
"telephone_number": "314-464-2094",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEROUSSE",
"first_name": "MADISON",
"credential": "PLPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-30",
"last_updated": "2025-05-14",
"certification_date": "2025-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MO",
"license": "2024014799",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirkwood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.