Individual provider Active NPI

Alexandra Marie Graves, MA, LMFT

  • Marriage & Family Therapist
  • Saint Charles, MO
National Provider Identifier
1568751402
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2022027082 Issued in MO
Practice address
2104 Collier Corporate Pkwy
Saint Charles, MO 63303-6708
Phone
(314) 833-9845
NPI assigned
Mar 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Marriage & Family Therapist 106H00000X 2022027082 MO Primary

Addresses

Primary practice location

2104 Collier Corporate Pkwy
Saint Charles, MO 63303-6708

Mailing address

2104 Collier Corporate Pkwy
Saint Charles, MO 63303-6708
Phone (314) 973-0742

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
I20231211003084 MO Practitioner - Marriage and Family Therapist 7416306832 Reassigns benefits to 1 organization
Practice locations: Saint Charles, MO

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2104 Collier Corporate Pkwy
Saint Charles, MO 63303-6708
Phone (314) 973-0742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2022027082MOMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
A W Stevenson LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

1310 Hrc Plaza Dr
Lake St Louis, MO 63367
Phone (636) 277-9890

400 N 5th St
Ste 201
Saint Charles, MO 63301
Phone (636) 238-2615

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": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1568751402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 COLLIER CORPORATE PKWY",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633036708",
            "telephone_number": "314-973-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 COLLIER CORPORATE PKWY",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633036708",
            "telephone_number": "314-833-9845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "ALEXANDRA",
        "middle_name": "MARIE",
        "credential": "MA,  LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MO",
            "license": "2022027082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.