Individual provider Active NPI

Alexandra Rogers, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1992563548
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2024002414 Issued in MO
Practice address
13303 Tesson Ferry Rd Ste 50
Saint Louis, MO 63128-4062
Phone
(636) 379-1779
NPI assigned
Mar 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2024002414 MO Primary

Addresses

Primary practice location

13303 Tesson Ferry Rd Ste 50
Saint Louis, MO 63128-4062

Mailing address

4450 Mohegan Dr
Saint Louis, MO 63123-6666

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
I20240419001275 MO Practitioner - Clinical Social Worker 1355780669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nystrom Counseling Mo PCGroup PAC ID 6103264494, 15 clinicians

Practice addresses (Care Compare)

13303 Tesson Ferry Rd
Suite 50
Saint Louis, MO 63128-4062
Phone (636) 379-1779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom Counseling Mo, PC CurrentSince Apr 1, 2024 Accepting new patients

Locations

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

13303 Tesson Ferry Rd
Ste 50
Saint Louis, MO 63128
Phone (314) 729-9995

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": "1709856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1992563548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 MOHEGAN DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631236666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13303 TESSON FERRY RD STE 50",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631284062",
            "telephone_number": "636-379-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "ALEXANDRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2024002414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.