Patricia A. Roosevelt, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2014034443 Issued in MO

Practice address

1023 Executive Parkway Dr Ste 10
Saint Louis, MO 63141-6323

Phone

(314) 469-5522

Fax

(314) 469-5504

NPI assigned

Jul 21, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Patricia a. Roosevelt LLC

  • Professional Counselor
  • Columbia, IL
  • NPI 1891288478
  Medicare reassignment NPD Authorized official
• Crossroads Christian Counseling

  • Professional Counselor
  • Saint Louis, MO
  • NPI 1477728400
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1679096648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 STANHOPE LN",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622363420",
            "telephone_number": "618-977-0734",
            "fax_number": "618-202-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 EXECUTIVE PARKWAY DR STE 10",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416323",
            "telephone_number": "314-469-5522",
            "fax_number": "314-469-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOSEVELT",
        "first_name": "PATRICIA",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-21",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2014034443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Paul Rood, MD
• Grace Mae Rook
• Jordan Elizabeth Rook, BCBA
• Maryssa Rook
• Melissa M Rooney, MD
• Tina Roostaei, MD, MPH
• Root & Rise Therapy and Wellness
• Root to Crown Wellness
• Benjamin Zimmerman Root, M.D.
• Rooted Healthcare LLC

• Professional Counselor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.