Tia L Kraemer, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2020001222 Issued in MO

Practice address

1310 HRC Plaza Dr
Lake St Louis, MO 63367-1869

Phone

(636) 339-4475

Fax

(636) 201-3379

NPI assigned

Nov 7, 2022

Last updated

Jan 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 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

Specialty

Mental Health Counselor

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

A W Stevenson LLCGroup PAC ID 8628437092, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• A W Stevenson LLC

  dba Ellie Mental Health

  • Professional Counselor
  • Saint Charles, MO
  • NPI 1396469060
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1679281919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 LORI LYNN CT",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633047475",
            "telephone_number": "314-392-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 HRC PLAZA DR",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671869",
            "telephone_number": "636-339-4475",
            "fax_number": "636-201-3379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 Highway W",
            "address_purpose": "LOCATION",
            "city": "Foristell",
            "state": "MO",
            "postal_code": "633481016",
            "country_code": "US",
            "telephone_number": "314-392-1138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N 5th St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633011808",
            "country_code": "US",
            "telephone_number": "636-238-2615",
            "fax_number": "636-201-3379",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "653 Lori Lynn Ct",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633047475",
            "country_code": "US",
            "telephone_number": "314-392-1138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRAEMER",
        "first_name": "TIA",
        "middle_name": "L",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2020001222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirks Eye Center, PC
• Marissa Kistner, M.ED., LPC
• Kathleen M. Kloeckner, ANP-BC
• Michelle J. Koerner, MED, LPC
• Melvin Eugene Kottwitz, RPH
• Robert Elroy Kraetsch, MD
• Andrew Edward Kreutzer
• Lana Marie Kruse, RD, LD
• Makayla Denise Kulpa
• Laboratory Corporation of America

• Professional Counselor in Lake St Louis, MO
• Providers in Lake St 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 15, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.